The Bodhi Tree, a Licensed Clinical Social Worker Corp

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

THE BODHI TREE, A LICENSED CLINICAL SOCIAL WORKER CORP

Practice address

7355 Church St Ste a
Yucca Valley, CA 92284-3273

Phone

(760) 517-3377

Fax

(760) 517-3377

NPI assigned

Mar 30, 2023

Organization subpart

No

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

Authorized official

Name

Mr. Brad K Nyman, LCSWNPI 1679807499

Title

President/Lead Therapist

Phone

(949) 294-8627

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brad K Nyman, LCSW

  • Clinical Social Worker
  • Yucca Valley, CA
  • NPI 1679807499
  NPD Authorized official
• Alison Iwaskow, LMFT

  • Marriage & Family Therapist
  • Yucca Valley, CA
  • NPI 1144964537
  NPD

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

{
    "created_epoch": "1680134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680134400000",
    "number": "1831894963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7355 CHURCH ST STE A",
            "city": "YUCCA VALLEY",
            "state": "CA",
            "postal_code": "922843273",
            "telephone_number": "760-517-3377",
            "fax_number": "760-517-3377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7355 CHURCH ST STE A",
            "city": "YUCCA VALLEY",
            "state": "CA",
            "postal_code": "922843273",
            "telephone_number": "760-517-3377",
            "fax_number": "760-517-3377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE BODHI TREE, A LICENSED CLINICAL SOCIAL WORKER CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-30",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A",
        "authorized_official_last_name": "NYMAN",
        "authorized_official_first_name": "BRAD",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT/LEAD THERAPIST",
        "authorized_official_telephone_number": "949-294-8627",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Telecare Corp
• Telecare Corp
• Telecare Corporation
• Telecare Cwic MB
• Duane Kinne Tevis, M.D.
• The Thought Shoppe
• Sean R Thomas, MD
• Anne V. Thompson
• Tracey Thompson
• Nancy Lee Thornton, O.T.R./L.

• Clinical Social Worker in Yucca Valley, CA
• Providers in Yucca Valley, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.