Provider Demographics
NPI:1184270852
Name:HODGES, AUSTIN NEWMAN (MHC)
Entity type:Individual
Prefix:
First Name:AUSTIN
Middle Name:NEWMAN
Last Name:HODGES
Suffix:
Gender:M
Credentials:MHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 MONROE PL APT 4
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-4623
Mailing Address - Country:US
Mailing Address - Phone:936-581-9289
Mailing Address - Fax:
Practice Address - Street 1:225 BROADWAY STE 1605
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10007-3756
Practice Address - Country:US
Practice Address - Phone:212-693-4010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-17
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP11850101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health