Individual provider · Type 1 NPI

Heather Jordan Boddie-Russo, LCSW

Clinical Social Worker · San Jose, CA

NPI number 1588090286 Active

Practice location

2101 Alexian Dr, Suite D
San Jose, CA 95116-1901

Call (408) 272-6513 Map

Fax (408) 272-6557

Mailing address

1671 The Alameda, Ste 306
San Jose, CA 95126-2222

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700XLCS 29058 (CA)

Clinical Social Worker: 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 interpers…

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About NPI 1588090286

Heather Jordan Boddie-Russo, LCSW's National Provider Identifier is 1588090286, issued on Sep 25, 2013. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in San Jose, CA. The record was last updated on Jul 30, 2018.