Provider Demographics
NPI:1689711830
Name:HODAN PSYCHOLOGICAL SERVICES
Entity Type:Organization
Organization Name:HODAN PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:J
Authorized Official - Last Name:RESSEL-HODAN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:727-399-0806
Mailing Address - Street 1:734 37TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33704-1620
Mailing Address - Country:US
Mailing Address - Phone:727-743-4149
Mailing Address - Fax:866-469-3880
Practice Address - Street 1:3745 5TH AVE N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-7519
Practice Address - Country:US
Practice Address - Phone:727-399-0806
Practice Address - Fax:866-469-3880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY5343103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty