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General NPI Number Information
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NPI Number | 1669387627
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Entity Type | Individual
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Provider Name | MARK D HODGE
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Gender | Male
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Dates
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Enumeration Date | 08/15/2026
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Last Update Date | 08/15/2026
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Provider Practice Location Address
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Address Line | 105 CONTINENTAL PL STE 105
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City | BRENTWOOD
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State | TN
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Zip | 37027-1119
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Country | US
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Telephone | 615-205-6047
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Fax | 615-534-2186
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Provider Business Mailing Address
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Address Line | 7208 DEERVALLEY DR
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City | FAIRVIEW
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State | TN
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Zip | 37062-1409
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Country | US
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Telephone |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 3464
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License Number State | TN
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