Healthcare Provider Details

I. General information

NPI: 1629989025
Provider Name (Legal Business Name): ANGELA M HODGES PSW, LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANGIE HODGES PSW, LMSW

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2888 NADEAU RD
MONROE MI
48162-9334
US

IV. Provider business mailing address

1101 S RAISINVILLE RD
MONROE MI
48161-9047
US

V. Phone/Fax

Practice location:
  • Phone: 734-289-5575
  • Fax:
Mailing address:
  • Phone: 734-771-2058
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number6801081829
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: