Provider Demographics
NPI:1790476836
Name:HODGE, HEATHER (EDS, NCSP, LPC)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:HODGE
Suffix:
Gender:F
Credentials:EDS, NCSP, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8260 IRIS CT
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80005-2140
Mailing Address - Country:US
Mailing Address - Phone:720-239-2443
Mailing Address - Fax:
Practice Address - Street 1:8260 IRIS CT
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80005-2140
Practice Address - Country:US
Practice Address - Phone:720-239-2443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-18
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0013327101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health