Provider Demographics
NPI:1275512436
Name:HODSON, ROBERTA J (LICSW)
Entity Type:Individual
Prefix:MS
First Name:ROBERTA
Middle Name:J
Last Name:HODSON
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 HENDERSON RD.
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02420-1604
Mailing Address - Country:US
Mailing Address - Phone:781-863-8356
Mailing Address - Fax:781-963-8356
Practice Address - Street 1:271 LINCOLN ST.
Practice Address - Street 2:UNIT #1
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02421
Practice Address - Country:US
Practice Address - Phone:781-863-8356
Practice Address - Fax:781-863-8356
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-15
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1027861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP02839OtherBLUECROSS NUMBER