DESIREA L SENIOR BODIFORD (LPC) – Professional Counselor, NPI 1124704689

DESIREA L SENIOR BODIFORD (LPC) is a healthcare provider. based in San angelo, Texas. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials LPC. They hold a License No. 84337 (TX). The NPI Number for DESIREA L SENIOR BODIFORD (LPC) is 1124704689

Main info

Female
7 Years Of Experience
Accepts Medicare Assignment
Name
DESIREA L SENIOR BODIFORD (LPC)
NPI
1124704689
Phone
(325) 944-2561
Address
36 E TWOHIG AVE STE 600
Enumeration Date
27 June 2023
Last Update Date
8 October 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3259442561
Graduation Year
2019 (7 years ago)
PAC ID
1254789811
Group Practice PAC ID
3870576937
Professional Enrollment ID
I20240216001234
Address ID
TX769036486SA36XXXAVEX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

3,949 MENTAL HEALTH COUNSELOR in TX

Provider Addresses for DESIREA L SENIOR BODIFORD (LPC)

  • 36 E TWOHIG AVE STE 600

    SAN ANGELO, TX 769036433

    Phone: (325) 944-2561

    Fax: (325) 653-4218

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-02-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240216001234IMental Health CounselorTXTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 76903)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3870576937View full group profile
NameSpecialtyState
Clinical Social WorkerTX
-TX
Clinical Social WorkerTX
Clinical Social WorkerTX
Mental Health CounselorTX
Clinical Social WorkerTX
Clinical Social WorkerTX
Mental Health CounselorTX
Mental Health CounselorTX
Mental Health CounselorTX

Reviews

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Frequently asked questions

How do payers reference DESIREA L SENIOR BODIFORD (LPC)?
For DESIREA L SENIOR BODIFORD (LPC), use NPI 1124704689 as the unique 10-digit identifier.
Is DESIREA L SENIOR BODIFORD (LPC) shown as active in public data?
Registry records indicate DESIREA L SENIOR BODIFORD (LPC) maintains an active NPI.
What kind of doctor is DESIREA L SENIOR BODIFORD (LPC)?
DESIREA L SENIOR BODIFORD (LPC) is associated with Professional Counselor in the directory — Clinical services aligned with this taxonomy classification.
Where in Texas is DESIREA L SENIOR BODIFORD (LPC) registered?
Use San Angelo, Texas as the headline location for DESIREA L SENIOR BODIFORD (LPC) here.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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