Provider Demographics
NPI:1932323524
Name:HODOS, KAYCE (LPC)
Entity Type:Individual
Prefix:
First Name:KAYCE
Middle Name:
Last Name:HODOS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:833 WAKE FOREST BUSINESS PARK STE H
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-7184
Mailing Address - Country:US
Mailing Address - Phone:919-414-0979
Mailing Address - Fax:866-652-9026
Practice Address - Street 1:833 WAKE FOREST BUSINESS PARK STE H
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-7184
Practice Address - Country:US
Practice Address - Phone:919-414-0979
Practice Address - Fax:866-652-9026
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5503101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6103524Medicaid