Provider Demographics
NPI:1538488184
Name:HODGE-WINDOVER, SHEILA THELMA (MS, LMFT)
Entity Type:Individual
Prefix:MRS
First Name:SHEILA
Middle Name:THELMA
Last Name:HODGE-WINDOVER
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7990
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73506-1990
Mailing Address - Country:US
Mailing Address - Phone:580-483-6031
Mailing Address - Fax:580-209-4699
Practice Address - Street 1:1711 SW D AVE
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73501-4443
Practice Address - Country:US
Practice Address - Phone:580-699-7654
Practice Address - Fax:580-209-4699
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-21
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100746700Medicaid