Kyeisha Hodge, M.S.ED.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LH60680488 Issued in WA

Practice address

29 Richard Ave
West Caldwell, NJ 07006-7245

Phone

(646) 420-7750

NPI assigned

Jun 25, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Realization Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • New York, NY
  • NPI 1972932465
  NPD (past)
• Realization Center, Inc.

  • Clinic/Center
  • New York, NY
  • NPI 1699827345
  NPD (past)

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

{
    "created_epoch": "1372118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1306286240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 RICHARD AVE",
            "city": "WEST CALDWELL",
            "state": "NJ",
            "postal_code": "070067245",
            "telephone_number": "646-420-7750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 RICHARD AVE",
            "city": "WEST CALDWELL",
            "state": "NJ",
            "postal_code": "070067245",
            "telephone_number": "646-420-7750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HODGE",
        "first_name": "KYEISHA",
        "credential": "M.S.ED.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-25",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60680488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Casi Michelle Healey, MA, BCBA
• Nicole-Marie Helmstetter, MA, LPC
• Danielle Olivia Hicks, OTR/L
• Lorraine Nina Hindy, DMD
• Bruce I Hirshorn, D.M.D.
• Rachel Hoffman, PT, DPT
• Melissa Holland
• Timothy Ryan Holland
• Tara P Horvat, M.A. CCC-SLP
• Jamie Nicole Hreniuk, DPT

• Mental Health Counselor in West Caldwell, NJ
• Providers in West Caldwell, NJ by specialty
• Mental Health Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; 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.