Provider Demographics
NPI:1902056567
Name:HODGES, EILEEN R (LCSW)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:R
Last Name:HODGES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1044 LEESBURG DR
Mailing Address - Street 2:
Mailing Address - City:LELAND
Mailing Address - State:NC
Mailing Address - Zip Code:28451-9386
Mailing Address - Country:US
Mailing Address - Phone:201-294-8545
Mailing Address - Fax:201-358-1386
Practice Address - Street 1:1044 LEESBURG DR
Practice Address - Street 2:
Practice Address - City:LELAND
Practice Address - State:NC
Practice Address - Zip Code:28451-9386
Practice Address - Country:US
Practice Address - Phone:201-294-8545
Practice Address - Fax:201-358-1386
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-19
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC053627001041C0700X
NCC0101431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical