Healthcare Provider Details

I. General information

NPI: 1427540400
Provider Name (Legal Business Name): MEREDITH HODGES LCPC, LCAC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2018
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 E 23RD ST
LAWRENCE KS
66046-4801
US

IV. Provider business mailing address

PO BOX 356
BALDWIN CITY KS
66006-0356
US

V. Phone/Fax

Practice location:
  • Phone: 785-521-3321
  • Fax:
Mailing address:
  • Phone: 785-893-4494
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number03364
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: