Provider Demographics
NPI:1699986430
Name:HODGES, NANCY L (LCSW LMFT)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:L
Last Name:HODGES
Suffix:
Gender:F
Credentials:LCSW LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 THERESA DR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-2039
Mailing Address - Country:US
Mailing Address - Phone:609-219-1222
Mailing Address - Fax:609-219-1777
Practice Address - Street 1:716 EXECUTIVE DR
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-1529
Practice Address - Country:US
Practice Address - Phone:609-683-5343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC006018001041C0700X
NJFI00074100106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist