Provider Demographics
NPI:1013391713
Name:HODGKIN, DUSTIN T (MS, LMFT)
Entity type:Individual
Prefix:
First Name:DUSTIN
Middle Name:T
Last Name:HODGKIN
Suffix:
Gender:M
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6306 S MALACHITE CV
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-2774
Mailing Address - Country:US
Mailing Address - Phone:435-359-1473
Mailing Address - Fax:435-359-1473
Practice Address - Street 1:4617 S PIONEER RD STE 101G
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-5156
Practice Address - Country:US
Practice Address - Phone:435-359-1473
Practice Address - Fax:435-359-1473
Is Sole Proprietor?:No
Enumeration Date:2015-07-13
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 101Y00000X
WALF60821964106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor