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NPI Code Detail

MEDICARE: JESSICA FAITH HODGES LCSW

MEDICARE: JESSICA FAITH HODGES LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker4212OK
21041C0700XClinical Social Worker5065OK
31041C0700XClinical Social Worker05761KS

General Provider Information

NPI Number : 1316223225
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA FAITH HODGES LCSW
Provider Business Mailing Address
First Line : 720 POYNTZ AVE
Second Line :
City : MANHATTAN
State : KS
Zip : 66502-6355
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 720 POYNTZ AVE
Second Line :
City : MANHATTAN
State : KS
Zip : 66502-6355
Country : US
Telephone Number : 785-320-7331
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2011
Last Update Date : 09/29/2022

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Directions to “ JESSICA FAITH HODGES LCSW” Practice Location

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