Provider Demographics
NPI:1326732108
Name:BODES, HANNAH (LCMHCA)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:BODES
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2045 MARTHA ELLEN RD
Mailing Address - Street 2:
Mailing Address - City:YADKINVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27055-6356
Mailing Address - Country:US
Mailing Address - Phone:701-426-0051
Mailing Address - Fax:
Practice Address - Street 1:239 HOMESTEAD RD
Practice Address - Street 2:
Practice Address - City:HARMONY
Practice Address - State:NC
Practice Address - Zip Code:28634-9448
Practice Address - Country:US
Practice Address - Phone:704-928-7360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-06
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA18792101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor