Provider Demographics
NPI:1265207898
Name:HODSON, CAROL PATRICIA (LPC, LMHC, SEP)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:PATRICIA
Last Name:HODSON
Suffix:
Gender:F
Credentials:LPC, LMHC, SEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:422 OAK STREET
Mailing Address - Street 2:
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63119-2235
Mailing Address - Country:US
Mailing Address - Phone:314-757-7365
Mailing Address - Fax:
Practice Address - Street 1:422 OAK STREET
Practice Address - Street 2:
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63119-2235
Practice Address - Country:US
Practice Address - Phone:314-757-7365
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2023018725101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health