Provider Demographics
NPI:1417749417
Name:HODGE, CELESTE VICTORIA
Entity type:Individual
Prefix:
First Name:CELESTE
Middle Name:VICTORIA
Last Name:HODGE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 ARIA WAY
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33837-9057
Mailing Address - Country:US
Mailing Address - Phone:516-423-2117
Mailing Address - Fax:
Practice Address - Street 1:5051 CASTELLO DR STE 35
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-8984
Practice Address - Country:US
Practice Address - Phone:941-500-4102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician