MEDICARE: CHERYL G HODGSON MA, NCC, LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	6916	NC

General Provider Information

NPI Number	:	1477788073
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHERYL G HODGSON MA, NCC, LPC

Provider Business Mailing Address
First Line	:	1931 J N PEASE PL
Second Line	:	SUITE 101
City	:	CHARLOTTE
State	:	NC
Zip	:	28262-4544
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1931 J N PEASE PL
Second Line	:	SUITE 101
City	:	CHARLOTTE
State	:	NC
Zip	:	28262-4544
Country	:	US
Telephone Number	:	704-962-5502
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2009
Last Update Date	:	09/27/2013

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