Provider Demographics
NPI:1154462067
Name:HOGAN, FREDERICK JOSEPH II (MA, LPC)
Entity Type:Individual
Prefix:
First Name:FREDERICK
Middle Name:JOSEPH
Last Name:HOGAN
Suffix:II
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11111 HALL RD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:UTICA
Mailing Address - State:MI
Mailing Address - Zip Code:48317-5711
Mailing Address - Country:US
Mailing Address - Phone:586-997-3153
Mailing Address - Fax:586-997-4956
Practice Address - Street 1:11111 HALL RD
Practice Address - Street 2:SUITE 303
Practice Address - City:UTICA
Practice Address - State:MI
Practice Address - Zip Code:48317-5711
Practice Address - Country:US
Practice Address - Phone:586-997-3153
Practice Address - Fax:586-997-4956
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401007340101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional