Deshika Venezio Bodhi Jackson, MSW, LSWAIC
Social Worker in Seattle, WA. Individual provider (NPI-1).
NPI number1164065108
StatusActive
Last updated in NPPESJul 28, 2026
Details
- NPI
- 1164065108
- Entity type
- Individual (NPI-1)
- Name
- Deshika Venezio Bodhi Jackson
- Credential
- MSW, LSWAIC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 22, 2019
- Certification date
- Jul 28, 2026
- Last updated
- Jul 28, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 104100000X | Social Worker | 60997028 | WA | Yes |
| 1041C0700X | Social Worker, Clinical | SWI.LW.61395765 | WA | |
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | CDPT.CO.70090832 | WA |
Other names
- Deshikia Venezio Bodhi-Jackson (Other Name)
Practice location
611 12th Ave SSeattle, WA 98144-2007
Phone 206-324-9360
Mailing address
611 12th Ave SSeattle, WA 98144-2007
Phone 206-324-9360
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