Individual provider Active NPI

Odyssey Nicole Holloman

  • Assistant Behavior Analyst
  • Grand Rapids, MI
National Provider Identifier
1992652721
Registry record updated Mar 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assistant Behavior AnalystTaxonomy code 106E00000X
Practice address
600 3 Mile Rd NW
Grand Rapids, MI 49544-1685
Phone
(855) 832-6727
NPI assigned
Mar 11, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assistant Behavior Analyst 106E00000X MI Primary

Addresses

Primary practice location

600 3 Mile Rd NW
Grand Rapids, MI 49544-1685

Mailing address

1428 E Alcott St
Kalamazoo, MI 49001-4345
Phone (859) 755-6304

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1773187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773187200000",
    "number": "1992652721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1428 E ALCOTT ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490014345",
            "telephone_number": "859-755-6304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 3 MILE RD NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495441685",
            "telephone_number": "855-832-6727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLOMAN",
        "first_name": "ODYSSEY",
        "middle_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-03-11",
        "last_updated": "2026-03-11",
        "certification_date": "2026-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2026; 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.