Healthcare Provider Details

I. General information

NPI: 1033021878
Provider Name (Legal Business Name): NIKIA BODDEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39 BOYLSTON ST FL 6
BOSTON MA
02116-4702
US

IV. Provider business mailing address

39 BOYLSTON ST FL 6
BOSTON MA
02116-4702
US

V. Phone/Fax

Practice location:
  • Phone: 617-457-1037
  • Fax: 617-542-4705
Mailing address:
  • Phone: 617-457-1037
  • Fax: 617-542-4705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: