Maurita Marice Hodge, ED.D, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC006683 Issued in GA

Practice address

4637 Ravenwood Loop
Union City, GA 30291-6037

Phone

(770) 306-6127

Fax

(770) 995-1959

NPI assigned

Feb 6, 2012

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1328486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660694400000",
    "number": "1184996175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4637 RAVENWOOD LOOP",
            "city": "UNION CITY",
            "state": "GA",
            "postal_code": "302916037",
            "telephone_number": "770-306-6127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4637 RAVENWOOD LOOP",
            "city": "UNION CITY",
            "state": "GA",
            "postal_code": "302916037",
            "telephone_number": "770-306-6127",
            "fax_number": "770-995-1959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HODGE",
        "first_name": "MAURITA",
        "middle_name": "MARICE",
        "name_prefix": "Dr.",
        "credential": "ED.D, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-06",
        "last_updated": "2022-08-17",
        "certification_date": "2022-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC006683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Union City, GA
• Providers in Union City, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.