Provider Demographics
NPI:1205567435
Name:HOGAN, EMILY CHRISTINE (LCSWA)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:CHRISTINE
Last Name:HOGAN
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 HILLSTON LN
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28115-0038
Mailing Address - Country:US
Mailing Address - Phone:440-864-2266
Mailing Address - Fax:
Practice Address - Street 1:14740 STUMPTOWN RD
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-9569
Practice Address - Country:US
Practice Address - Phone:704-948-0231
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-20
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0161461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical