Bryan W Hodges, LISW, LADAC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I-05676 Issued in NM

Practice address

100 W Griggs Ave
Las Cruces, NM 88001-1234

Phone

(575) 647-2800

Fax

(575) 647-2898

NPI assigned

Apr 19, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424131200000",
    "number": "1720205719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 W GRIGGS AVE",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880011234",
            "telephone_number": "575-647-2800",
            "fax_number": "575-647-2898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W GRIGGS AVE",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880011234",
            "telephone_number": "575-647-2800",
            "fax_number": "575-647-2898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HODGES",
        "first_name": "BRYAN",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "LISW, LADAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-19",
        "last_updated": "2015-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NM",
            "license": "0081351",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "I-05676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "18677037",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shirley Jeanette Hinshaw, M.D.
• Laura M Hintermeier, DPT
• Sara Hipps, LMSW
• Tracie Hitter, PH.D.
• John Bryan Hock, DPT
• Kaitlyn Hodges
• Kathleen Nancy Hodges, LPCC
• Marti Jill Hoekenga-Rigg
• David Earl Hoekenga, M.D.
• Edyta Hoff

• Clinical Social Worker in Las Cruces, NM
• Providers in Las Cruces, NM by specialty
• Clinical Social Worker in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2015; 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.