MEDICARE: CANDICE R HOGDEN

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	104100000X	Social Worker	2243-123	WI
2	101Y00000X	Counselor		IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	103515	OTHER	IL	HEALTH ALLIANCE
2	236610	OTHER	IL	VALUE OPTIONS
3	357929	OTHER	IL	MHN
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	469922	OTHER	IL	HEALTHLINK
6	7230084	OTHER	IL	AETNA
7	07232101	OTHER	IL	BCBS

General Provider Information

NPI Number	:	1770650442
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CANDICE R HOGDEN

Provider Business Mailing Address
First Line	:	5016 N UNIVERSITY
Second Line	:	CHRISTUS LIGHT COUNSELING STE 109
City	:	PEORIA
State	:	IL
Zip	:	61614-4763
Country	:	US
Telephone Number	:	309-692-1220
Fax Number	:	309-692-1222

Provider Business Practice Location Address
First Line	:	5016 N UNIVERSITY
Second Line	:	CHRISTUS LIGHT COUNSELING STE 109
City	:	PEORIA
State	:	IL
Zip	:	61614-4763
Country	:	US
Telephone Number	:	309-692-1220
Fax Number	:	309-692-1222

Authorized Official
Title or Position	:	DIRECTOR COUNSELOR
Name	:	MS. CANDICE RAE HOGDEN
Credential	:	MS LCPC LCSW
Telephone Number	:	309-692-1220

Provider Enumeration Date	:	11/29/2006
Last Update Date	:	09/11/2025

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Directions to “CANDICE R HOGDEN ” Practice Location

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