Provider Demographics
NPI:1477724540
Name:HOAG, ALICE DRUSILLA (LPC, CPCS)
Entity Type:Individual
Prefix:DR
First Name:ALICE
Middle Name:DRUSILLA
Last Name:HOAG
Suffix:
Gender:F
Credentials:LPC, CPCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3739 SW RIDGE BLUFF OVERLOOK
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30507-3200
Mailing Address - Country:US
Mailing Address - Phone:706-768-9053
Mailing Address - Fax:678-893-5312
Practice Address - Street 1:185 WALLS COMPLEX CIR
Practice Address - Street 2:
Practice Address - City:CLARKESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30523-6223
Practice Address - Country:US
Practice Address - Phone:706-768-9053
Practice Address - Fax:678-893-5312
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-17
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1803101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional