Active NPI
Elaine Arena Hodge, EDD
- Clinical Psychologist
- Prescott, AZ
National Provider Identifier
1730119942
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 3531
- Practice address
- 211 Grove Ave
Prescott, AZ 86301-5737 - Phone
- (928) 848-0666
- Fax
- (928) 717-0064
- NPI assigned
- Jul 4, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 3531 | AZ | Primary |
Addresses
Primary practice location
211 Grove Ave
Prescott, AZ 86301-5737
Mailing address
606 Hummingbird Way
Prescott, AZ 86301-5737
Phone (928) 717-0064
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090407000327 | AZ | Practitioner - Clinical Psychologist | 0143377259 | Practice locations: Prescott, AZ |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1976
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
2765 S Forest Rd
Suite 28
Prescott, AZ 86303
Phone (928) 848-0666
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3531 | AZ | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1730119942",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "606 HUMMINGBIRD WAY",
"city": "PRESCOTT",
"state": "AZ",
"postal_code": "863015737",
"telephone_number": "928-717-0064",
"fax_number": "928-717-0064"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "211 GROVE AVE",
"city": "PRESCOTT",
"state": "AZ",
"postal_code": "863015737",
"telephone_number": "928-848-0666",
"fax_number": "928-717-0064"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HODGE",
"first_name": "ELAINE",
"middle_name": "ARENA",
"name_prefix": "Dr.",
"credential": "EDD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "AZ",
"license": "3531",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Prescott, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.