Provider Demographics
NPI:1538534615
Name:HODGE, RENA (LMFT)
Entity type:Individual
Prefix:
First Name:RENA
Middle Name:
Last Name:HODGE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2314
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-1228
Mailing Address - Country:US
Mailing Address - Phone:720-900-5109
Mailing Address - Fax:
Practice Address - Street 1:8751 E HAMPDEN AVE STE C2
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-4930
Practice Address - Country:US
Practice Address - Phone:720-900-5109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-01
Last Update Date:2024-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMFP.0001040106H00000X
COMFT.0001315106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist