Provider Demographics
NPI:1386126506
Name:HODGES, COREY MARIE (LMFT)
Entity type:Individual
Prefix:
First Name:COREY
Middle Name:MARIE
Last Name:HODGES
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:COREY
Other - Middle Name:MARIE
Other - Last Name:PRICE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4990 WILLIAMS AVE
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-7409
Mailing Address - Country:US
Mailing Address - Phone:619-668-4200
Mailing Address - Fax:
Practice Address - Street 1:4990 WILLIAMS AVE
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-7409
Practice Address - Country:US
Practice Address - Phone:619-668-4200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-04
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA156237106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist