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Deshika Venezio Bodhi Jackson , MSW, LSWAIC

Social Worker β€’ Seattle, WA

Active NPI 1164065108 Individual Practitioner Female Practitioner
Practice location in NPPES

611 12th Ave S
Seattle, WA 981442007

Call 2063249360 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

611 12th Ave S

Seattle, WA 981442007

Telephone 2063249360
Organization at the Same NPPES Address or Phone
Seattle Indian Health Board Facility NPI 1497820542

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2019

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Deshika Bodhi Jackson has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists Deshika Bodhi Jackson as eligible to order or refer Medicare Part B clinical laboratory and imaging services and durable medical equipment (DME) for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in Seattle and Washington

468 active clinicians are listed under Social Worker with a practice address in Seattle, WA (2,142 in Washington).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Seattle

0.9% of these 468 clinicians have the CMS telehealth indicator.

2.6% of these 468 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2026-07-28
Social Worker Primary Specialty

NUCC Taxonomy Code: 104100000X

License # reported to NPPES WA 60997028

A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.

Social Worker - Clinical

NUCC Taxonomy Code: 1041C0700X

License # reported to NPPES WA SWI.LW.61395765

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

Counselor - Addiction (Substance Use Disorder)

NUCC Taxonomy Code: 101YA0400X

License # reported to NPPES WA CDPT.CO.70090832
Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Washington State Department of Health Provider Lookup.
Look Up on State Board Site

Additional State Medicaid & Healthcare Payer Identifiers

Other Identifier Doh Lswaic Credential
60997028 (WA)

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

PRACTITIONER - CLINICAL SOCIAL WORKER

Medicare Enrollment ID

I20260624001319

Enrollment State Jurisdiction

WA

PECOS Control ID

3476026220

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Not Eligible
Power Mobility Devices (PMD) Not Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

14 listed
Dr. Amy Chabitnoy , MD

Family Medicine

NPI 1396108957

Doctor of Medicine (M.D.)

Dr. Veronica Couture , MD

Psychiatry & Neurology - Psychiatry

NPI 1770792764

Doctor of Medicine (M.D.)

Dr. Chloe Craig , DMD, MPH

Dentist - General Practice

NPI 1215459995

Doctor of Dental Medicine, Master of Public Health

Dr. Debra Fischer , ARNP, PhD

Nurse Practitioner - Family

NPI 1598743106

Advanced Registered Nurse Practitioner, Doctor of Philosophy (Ph.D.)

NPI 1023085495

Doctor of Medicine (M.D.)

Dr. Kara Harvill , MD

Family Medicine

NPI 1427554229

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

11 Historical Events
πŸ‘€
Provider Name / Credentials Updated May 13, 2026

Recorded as DESHIKA BODHI JACKSON, MSW, LSWAIC

πŸ“
Updated Practice Location May 07, 2026

Registered at 611 12TH AVE S, SEATTLE, WA 981442007 (Tel: 2063249360)

πŸ“
Updated Business Mailing Address May 07, 2026

Registered at 611 12TH AVE S, SEATTLE, WA 981442007 (Tel: 2063249360)

πŸ“
Updated Practice Location September 03, 2021

Registered at 13925 INTERURBAN AVE S STE 120, TUKWILA, WA 981685726 (Tel: 2064374415)

πŸ“
Updated Business Mailing Address September 03, 2021

Registered at 13925 INTERURBAN AVE S STE 120, TUKWILA, WA 981685726 (Tel: 2064374415)

βœ…
NPI Profile Active October 22, 2019

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) October 22, 2019

Registered at 316 BROADWAY, SEATTLE, WA 981225325 (Tel: 2063790992)

πŸ“
Business Mailing Address (Initial Record) October 22, 2019

Registered at 4230 THACKERAY PL NE, SEATTLE, WA 981056544 (Tel: 2063790992)

πŸ‘€
Provider Name / Credentials (Initial Record) October 22, 2019

Recorded as DESHIKA PERERA, MSW, LSWAIC

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) October 22, 2019

Social Worker (license number reported to NPPES: WA 60997028)

🟒
Initial NPI Registration & Enumeration October 22, 2019

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1164065108
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 22, 2019
Last Update: July 28, 2026
Sole Proprietor: No

Other Social Workers in Seattle

All Social Workers in Seattle

Mailing Address

611 12th Ave S

Seattle, WA 981442007

Phone: 2063249360

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.