Provider Demographics
NPI:1932402385
Name:HODGES, SUZANNA JO (LCSW)
Entity Type:Individual
Prefix:
First Name:SUZANNA
Middle Name:JO
Last Name:HODGES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SUZANNA
Other - Middle Name:JO
Other - Last Name:BUSH/SIMONTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1523 BROOKLEAF DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76018-3057
Mailing Address - Country:US
Mailing Address - Phone:469-323-3663
Mailing Address - Fax:
Practice Address - Street 1:1523 BROOKLEAF DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76018-3057
Practice Address - Country:US
Practice Address - Phone:469-323-3663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-07
Last Update Date:2021-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX292161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical