Provider Demographics
NPI:1487826400
Name:HODGES, JAMES D (LPC,)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:D
Last Name:HODGES
Suffix:
Gender:M
Credentials:LPC,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6171 CHILDERS RD
Mailing Address - Street 2:
Mailing Address - City:BARBOURSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25504-1227
Mailing Address - Country:US
Mailing Address - Phone:304-733-5380
Mailing Address - Fax:304-733-5796
Practice Address - Street 1:6171 CHILDERS RD
Practice Address - Street 2:
Practice Address - City:BARBOURSVILLE
Practice Address - State:WV
Practice Address - Zip Code:25504-1227
Practice Address - Country:US
Practice Address - Phone:304-733-5380
Practice Address - Fax:304-733-5796
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-31
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1721101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV1487826400Medicaid