Provider Demographics
NPI:1053485201
Name:HODAX, DONNA A (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:A
Last Name:HODAX
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6630 E EUGIE TER
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-3926
Mailing Address - Country:US
Mailing Address - Phone:602-448-8832
Mailing Address - Fax:480-393-3504
Practice Address - Street 1:5070 N 40TH ST
Practice Address - Street 2:200
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-2148
Practice Address - Country:US
Practice Address - Phone:602-448-8832
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW20131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical