Provider Demographics
NPI:1801949615
Name:HODGES, JEAN M (BS LCDC NCAC II)
Entity type:Individual
Prefix:
First Name:JEAN
Middle Name:M
Last Name:HODGES
Suffix:
Gender:F
Credentials:BS LCDC NCAC II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3031 W IH 10
Mailing Address - Street 2:THE CENTER FOR HEALTH CARE SERVICES
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78201-5159
Mailing Address - Country:US
Mailing Address - Phone:210-731-1320
Mailing Address - Fax:210-731-9661
Practice Address - Street 1:3031 W IH 10
Practice Address - Street 2:THE CENTER FOR HEALTH CARE SERVICES
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78201-5159
Practice Address - Country:US
Practice Address - Phone:210-731-1320
Practice Address - Fax:210-731-9661
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10978101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)