Provider Demographics
NPI:1477835387
Name:HODGES, ANNA LUCILLE (LMSW, CSW INTERN)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:LUCILLE
Last Name:HODGES
Suffix:
Gender:F
Credentials:LMSW, CSW INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5715 W ALEXANDER RD STE 115
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130-2815
Mailing Address - Country:US
Mailing Address - Phone:702-997-5567
Mailing Address - Fax:
Practice Address - Street 1:5715 W ALEXANDER RD STE 115
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-2815
Practice Address - Country:US
Practice Address - Phone:702-997-5567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-16
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
NVIC-1873104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator