Provider Demographics
NPI:1518943406
Name:HODGES, SANDI GALE (LPC)
Entity Type:Individual
Prefix:MS
First Name:SANDI
Middle Name:GALE
Last Name:HODGES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 OLD FRANKLIN TPKE
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:VA
Mailing Address - Zip Code:24151-5676
Mailing Address - Country:US
Mailing Address - Phone:540-484-6996
Mailing Address - Fax:
Practice Address - Street 1:2600 OLD FRANKLIN TPKE
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:VA
Practice Address - Zip Code:24151-5676
Practice Address - Country:US
Practice Address - Phone:540-484-6996
Practice Address - Fax:540-484-6935
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-21
Last Update Date:2008-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003548101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1518943406OtherNPI
VA010314810OtherVIRGINIA PREMIER
VA081047MOtherOPTIMA HEALTH
VA11526350OtherCAQH
VA62-02411OtherUNITED BEHAVIORAL HEALTH
VA081047MOtherSENTARA BEHAVIORAL HEALTH
VA180881OtherBCBS
VA2117903OtherMAMIS
VA247544OtherANTHEM BCBS
VA274370OtherCOMPSYCH
VA010196540Medicaid
VA0701003548OtherLICENSE PROFESSIONAL COUN
VA2190356OtherCIGNA
VA4634562OtherSENTARA
VA600059283OtherMEGELLAN