Healthcare Provider Details

I. General information

NPI: 1881506913
Provider Name (Legal Business Name): JODY R DODSON APC, CTP, NCC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1506 PACES FERRY NORTH DR SE
SMYRNA GA
30080-8201
US

IV. Provider business mailing address

1506 PACES FERRY NORTH DR SE
SMYRNA GA
30080-8201
US

V. Phone/Fax

Practice location:
  • Phone: 404-597-7270
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberAPC009983
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: