=====================================================
General NPI Number Information
=====================================================
NPI Number | 1902790900
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BRITTANY MARIE HODGES LMSW-P
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/04/2025
-----------------------------------------------------
Last Update Date | 06/04/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 501 E 15TH ST STE 400A
-----------------------------------------------------
City | EDMOND
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73013-5046
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 405-216-5240
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 12272 NS 3600
-----------------------------------------------------
City | SEMINOLE
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 74868-6531
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-772-5596
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 21662-P
-----------------------------------------------------
License Number State | OK
-----------------------------------------------------