Healthcare Provider Details

I. General information

NPI: 1396634127
Provider Name (Legal Business Name): DUSTIN HODGKIN PSYCHOTHERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2025
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4617 S PIONEER RD STE 101G
ST GEORGE UT
84790-5156
US

IV. Provider business mailing address

PO BOX 910804
ST GEORGE UT
84791-0804
US

V. Phone/Fax

Practice location:
  • Phone: 435-359-1473
  • Fax: 435-359-1473
Mailing address:
  • Phone: 360-302-3448
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: DUSTIN HODGKIN
Title or Position: PROVIDER & OWNER
Credential: M.S., LMFT
Phone: 435-359-1473