Deshika Venezio Bodhi Jackson, MSW, LSWAIC
NPI 1164065108ActiveIndividual· Social Worker· Seattle, WA
Social Worker (MSW, LSWAIC) in Seattle, Washington, licensed in WA, with an NPI issued in October 2019. Enrolled in Medicare as practitioner - clinical social worker.
Overview
| NPI | 1164065108 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | MSW, LSWAIC |
| Sole proprietor | No |
| NPI issued | Oct 22, 2019 |
| Last updated in NPPES | Jul 28, 2026 |
| Certified by provider | Jul 28, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker Primary | 104100000X | 60997028 | WA |
| Social Worker, Clinical | 1041C0700X | SWI.LW.61395765 | WA |
| Counselor, Addiction (Substance Use Disorder) | 101YA0400X | CDPT.CO.70090832 | WA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Social Worker (WA) |
|---|
Education and affiliations
| Graduation year | 2019 |
|---|---|
| Medicare specialty | Clinical Social Worker |
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