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General NPI Number Information
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NPI Number | 1922999317
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Entity Type | Individual
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Provider Name | RILEY HODGE
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Gender |
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Dates
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Enumeration Date | 07/14/2025
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Last Update Date | 08/11/2025
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Provider Practice Location Address
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Address Line | 7 PETTIGRU ST
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City | GREENVILLE
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State | SC
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Zip | 29601-3028
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Country | US
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Telephone | 864-235-7501
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Fax |
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Provider Business Mailing Address
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Address Line | 125 LONESTAR DR UNIT 1324
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City | EASLEY
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State | SC
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Zip | 29640-3994
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Country | US
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Telephone | 828-773-3077
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 10502
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License Number State | SC
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