Healthcare Provider Details

I. General information

NPI: 1316223225
Provider Name (Legal Business Name): JESSICA FAITH HODGES LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JESSICA FAITH CONWAY LCSW

II. Dates (important events)

Enumeration Date: 10/25/2011
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 SOUTHWIND PL
MANHATTAN KS
66503-3131
US

IV. Provider business mailing address

206 SOUTHWIND PL
MANHATTAN KS
66503-3131
US

V. Phone/Fax

Practice location:
  • Phone: 785-236-8623
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number05761
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: