MEDICARE: JAMES HODGES MA, LPC

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
1	101YM0800X	Mental Health Counselor	63125	TX

General Provider Information

NPI Number	:	1821549932
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES HODGES MA, LPC

Provider Business Mailing Address
First Line	:	1708 DAYTON AVE
Second Line	:
City	:	WICHITA FALLS
State	:	TX
Zip	:	76301-6110
Country	:	US
Telephone Number	:	214-244-7592
Fax Number	:	940-720-0018

Provider Business Practice Location Address
First Line	:	1708 DAYTON AVE
Second Line	:
City	:	WICHITA FALLS
State	:	TX
Zip	:	76301-6110
Country	:	US
Telephone Number	:	214-244-7592
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/24/2016
Last Update Date	:	05/11/2017

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