Provider Demographics
NPI:1457407660
Name:HOOD, C JEFFERSON III (PHD)
Entity Type:Individual
Prefix:DR
First Name:C
Middle Name:JEFFERSON
Last Name:HOOD
Suffix:III
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1508 TATE RD NW
Mailing Address - Street 2:
Mailing Address - City:FORT PAYNE
Mailing Address - State:AL
Mailing Address - Zip Code:35968-3045
Mailing Address - Country:US
Mailing Address - Phone:864-357-9568
Mailing Address - Fax:
Practice Address - Street 1:772 MCCURDY AVE S
Practice Address - Street 2:
Practice Address - City:RAINSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35986-5211
Practice Address - Country:US
Practice Address - Phone:256-279-7505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-28
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT 2087106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist