Provider Demographics
NPI:1609086529
Name:HODGINS, CHARLES EDWIN (MFT)
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:EDWIN
Last Name:HODGINS
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BOX 369
Mailing Address - Street 2:
Mailing Address - City:HOPE
Mailing Address - State:B.C.
Mailing Address - Zip Code:V0X1L0
Mailing Address - Country:CA
Mailing Address - Phone:604-869-5071
Mailing Address - Fax:604-869-2105
Practice Address - Street 1:BOX 369
Practice Address - Street 2:
Practice Address - City:HOPE
Practice Address - State:B.C.
Practice Address - Zip Code:V0X 1L0
Practice Address - Country:CA
Practice Address - Phone:604-869-5071
Practice Address - Fax:604-869-2105
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
19421101Y00000X, 101YM0800X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
19421OtherCHILD & YOUTH MENTAL HEAL