Individual provider Active NPI

Terra Demetria Hodge, LCAS, LCSW-A

  • Clinical Social Worker
  • Durham, NC
National Provider Identifier
1699144279
Registry record updated Sep 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P008828 Issued in NC
Practice address
305 Harkness Cir
Durham, NC 27705-7363
Phone
(919) 389-0801
NPI assigned
Sep 24, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LCAS-20382 NC
Clinical Social Worker 1041C0700X P008828 NC Primary

Addresses

Primary practice location

305 Harkness Cir
Durham, NC 27705-7363

Mailing address

305 Harkness Cir
Durham, NC 27705-7363
Phone (919) 389-0801

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170517001746 NC Practitioner - Clinical Social Worker 7315214673 Practice locations: Durham, NC

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

305 Harkness Cir
Durham, NC 27705-7363
Phone (919) 389-0801

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCAS-20382NCMDAddiction (Substance Use Disorder) Counselor
P008828NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Terra Hodge Clinical CurrentSince Jan 1, 2017 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1443052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663027200000",
    "number": "1699144279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 HARKNESS CIR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277057363",
            "telephone_number": "919-389-0801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 HARKNESS CIR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277057363",
            "telephone_number": "919-389-0801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HODGE",
        "first_name": "TERRA",
        "middle_name": "DEMETRIA",
        "credential": "LCAS, LCSW-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-24",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS-20382",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P008828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.