Provider Demographics
NPI:1750688669
Name:HODGINS, SHANNON
Entity Type:Individual
Prefix:MRS
First Name:SHANNON
Middle Name:
Last Name:HODGINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7474 GREENWAY CENTER DR
Mailing Address - Street 2:SUITE 730
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-3504
Mailing Address - Country:US
Mailing Address - Phone:301-345-1022
Mailing Address - Fax:301-560-5558
Practice Address - Street 1:1003 W 7TH ST
Practice Address - Street 2:SUITE 500
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-4106
Practice Address - Country:US
Practice Address - Phone:301-345-1022
Practice Address - Fax:301-560-5558
Is Sole Proprietor?:No
Enumeration Date:2011-02-13
Last Update Date:2016-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD130141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical