Hodges, Bryan W
Hodges, Bryan W is an individual health care provider with primary practice located at 100 W Griggs Ave , Las Cruces NM 88001-1234. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Hodges, Bryan W can be contacted via phone (575) 647-2800.Contact Information
Primary practice address
100 W Griggs Ave
Las Cruces NM 88001-1234
Phone: (575) 647-2800
Fax: (575) 647-2898
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 0081351 | New Mexico |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | I-05676 | New Mexico |
Profile Details
| NPI number | 1720205719 |
|---|---|
| LBN Legal business name | Hodges, Bryan W |
| Credentials | LISW, LADAC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 19th, 2007 |
| Last updated | Feb 17th, 2015 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1720205719 | NPPES |
| New Mexico | MEDICAID | 18677037 |
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