Jaee Bodas, PH.D. LCP

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

0810003928 Issued in VA

Practice address

5230 Hickory Park Dr Ste a
Glen Allen, VA 23059-2628

Phone

(804) 402-1513

Fax

(804) 533-5313

NPI assigned

Jun 11, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Interoperability endpoints

• Direct secure messaging: jbodas@ccbtonline.com

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

{
    "created_epoch": "1213142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773273600000",
    "number": "1841450053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11805 COOLWIND LN",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232331788",
            "telephone_number": "804-402-1513",
            "fax_number": "804-533-5313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5230 HICKORY PARK DR STE A",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230592628",
            "telephone_number": "804-402-1513",
            "fax_number": "804-533-5313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODAS",
        "first_name": "JAEE",
        "name_prefix": "Dr.",
        "credential": "PH.D. LCP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-11",
        "last_updated": "2026-03-12",
        "certification_date": "2026-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "VA",
            "license": "0810003928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbodas@ccbtonline.com",
            "affiliation": "N",
            "endpointDescription": "Work email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "5230 Hickory Park Dr Ste A",
            "city": "Glen Allen",
            "state": "VA",
            "country_code": "US",
            "postal_code": "230592628",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Clinical Child & Adolescent Psychologist in Glen Allen, VA
• Providers in Glen Allen, VA by specialty
• Clinical Child & Adolescent Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2026; 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.