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General NPI Number Information
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NPI Number | 1629414594
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Entity Type | Individual
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Provider Name | WILLIAM MURRAY HODGE LCSW/CEAP
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Gender | Male
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Dates
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Enumeration Date | 05/17/2013
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Last Update Date | 05/17/2013
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Provider Practice Location Address
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Address Line | 1401 1ST STREET
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City | GULF SHORES
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State | AL
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Zip | 36542
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Country | US
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Telephone | 251-834-4622
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Fax |
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Provider Business Mailing Address
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Address Line | 139 LAGOON DR
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City | GULF SHORES
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State | AL
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Zip | 36542-8217
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Country | US
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Telephone | 251-948-3976
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 1499C
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 1499C
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License Number State | AL
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