Individual provider Active NPI

Tricia Boodhoo, LCSW

  • Clinical Social Worker
  • Ysleta del Sur Pueblo, TX
National Provider Identifier
1992261465
Registry record updated May 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
57237 Issued in TX
Practice address
9314 Juanchido LN
Ysleta del Sur Pueblo, TX 79907-6832
Phone
(915) 860-6110
NPI assigned
Feb 20, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 57237 TX
Clinical Social Worker 1041C0700X 57237 TX Primary

Addresses

Primary practice location

9314 Juanchido LN
Ysleta del Sur Pueblo, TX 79907-6832

Mailing address

9314 Juanchido LN
Ysleta del Sur Pueblo, TX 79907-6832

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
57237TXMDAmbulatory Care Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1550620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747785600000",
    "number": "1992261465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9314 JUANCHIDO LN",
            "city": "YSLETA DEL SUR PUEBLO",
            "state": "TX",
            "postal_code": "799076832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9314 JUANCHIDO LN",
            "city": "YSLETA DEL SUR PUEBLO",
            "state": "TX",
            "postal_code": "799076832",
            "telephone_number": "915-860-6110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOODHOO",
        "first_name": "TRICIA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-20",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TX",
            "license": "57237",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "57237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ysleta del Sur Pueblo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2025; 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.