Provider Demographics
NPI:1194136309
Name:HODGES, REBECCA JO (LPC)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:JO
Last Name:HODGES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:JO
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:3327 NANSEMOND RIVER DR
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23435-1057
Mailing Address - Country:US
Mailing Address - Phone:757-809-0909
Mailing Address - Fax:
Practice Address - Street 1:3327 NANSEMOND RIVER DR
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23435-1057
Practice Address - Country:US
Practice Address - Phone:757-809-0909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-12
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701005635101YP2500X
WI2949-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional