Provider Demographics
NPI:1982496659
Name:HODGES, NICHOLAS TAYLOR
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:TAYLOR
Last Name:HODGES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 PEACHTREE AVE NE APT 416
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-3037
Mailing Address - Country:US
Mailing Address - Phone:480-200-4537
Mailing Address - Fax:
Practice Address - Street 1:48 PEACHTREE AVE NE APT 416
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305-3037
Practice Address - Country:US
Practice Address - Phone:480-200-4537
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-20
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst