Provider Demographics
NPI:1083914535
Name:HODGDON, WILLIAM (LCSW)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:
Last Name:HODGDON
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 COLD INDIAN SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:OCEAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-3223
Mailing Address - Country:US
Mailing Address - Phone:732-918-8842
Mailing Address - Fax:
Practice Address - Street 1:227 COLD INDIAN SPRINGS RD
Practice Address - Street 2:
Practice Address - City:OCEAN
Practice Address - State:NJ
Practice Address - Zip Code:07712-3223
Practice Address - Country:US
Practice Address - Phone:732-918-8842
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-01
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC004005001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical