Organization Active NPI

Neurobloom Solutions ABA LLC

  • Behavior Analyst
  • Lithonia, GA
National Provider Identifier
1013899277
Registry record updated Jul 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
NEUROBLOOM SOLUTIONS ABA LLC
Practice address
2147 Silver Thorn CT
Lithonia, GA 30058-3585
Phone
(470) 698-1976
NPI assigned
Jul 21, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Philanda Davina-Marie Hodges
Title
Board Certified Behavior Analyst
Phone
(470) 698-1976

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X Primary

Addresses

Primary practice location

2147 Silver Thorn CT
Lithonia, GA 30058-3585

Mailing address

2147 Silver Thorn CT
Lithonia, GA 30058-3585
Phone (470) 698-1976

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1753056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753056000000",
    "number": "1013899277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2147 SILVER THORN CT",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300583585",
            "telephone_number": "470-698-1976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2147 SILVER THORN CT",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300583585",
            "telephone_number": "470-698-1976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROBLOOM SOLUTIONS ABA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-21",
        "last_updated": "2025-07-21",
        "certification_date": "2025-07-21",
        "status": "A",
        "authorized_official_last_name": "HODGES",
        "authorized_official_first_name": "PHILANDA",
        "authorized_official_middle_name": "DAVINA-MARIE",
        "authorized_official_title_or_position": "BOARD CERTIFIED BEHAVIOR ANALYST",
        "authorized_official_telephone_number": "470-698-1976"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lithonia, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.