Provider Demographics
NPI:1629414594
Name:HODGE, WILLIAM MURRAY (LCSW/CEAP)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:MURRAY
Last Name:HODGE
Suffix:
Gender:M
Credentials:LCSW/CEAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 LAGOON DR
Mailing Address - Street 2:
Mailing Address - City:GULF SHORES
Mailing Address - State:AL
Mailing Address - Zip Code:36542-8217
Mailing Address - Country:US
Mailing Address - Phone:251-948-3976
Mailing Address - Fax:
Practice Address - Street 1:1401 1ST STREET
Practice Address - Street 2:
Practice Address - City:GULF SHORES
Practice Address - State:AL
Practice Address - Zip Code:36542
Practice Address - Country:US
Practice Address - Phone:251-834-4622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-17
Last Update Date:2013-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1499C101Y00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor