Jordan Elizabeth Small-Bodhare, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

83238 Issued in TX

Practice address

4144 N Central Expy Ste 850
Dallas, TX 75204-3226

Phone

(512) 956-6463

NPI assigned

May 2, 2022

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Deep Eddy Psychotherapy Management, LLCGroup PAC ID 2264886936, 70 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Deep Eddy Psychotherapy Management, LLC

  • Counseling Psychologist
  • Austin, TX
  • NPI 1457740862
  Medicare reassignment Care Compare group NPD
• Deep Centered Psychiatry PLLC

  • Psychiatry Physician
  • Austin, TX
  • NPI 1629853825
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1651449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787184000000",
    "number": "1548905771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8409 SEQUOIA WAY",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761375752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4144 N CENTRAL EXPY STE 850",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752043226",
            "telephone_number": "512-956-6463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMALL-BODHARE",
        "first_name": "JORDAN",
        "middle_name": "ELIZABETH",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-02",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "83238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Norman Slusher, M.D.
• Shawn W Slywka, M.D.
• Sma Group Incorporated
• Anna Smaistrla
• Small Talk Speech, Language, & Social Skills, PLLC
• Anna M. Small, FNP
• Carl Everett Small Jr., DC
• Gregg L. Small, M.D.
• Gregory James Small, C.O., L.O.
• Hunter Small, PHD

• Mental Health Counselor in Dallas, TX
• Providers in Dallas, TX by specialty
• Mental Health Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.