Provider Demographics
NPI:1104278175
Name:HODGE, JANEECE (LCSW)
Entity type:Individual
Prefix:
First Name:JANEECE
Middle Name:
Last Name:HODGE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 BEECH ST.
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50703-4046
Mailing Address - Country:US
Mailing Address - Phone:319-883-3067
Mailing Address - Fax:319-883-3069
Practice Address - Street 1:515 BEECH ST
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50703-3317
Practice Address - Country:US
Practice Address - Phone:319-883-3067
Practice Address - Fax:319-883-3069
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-01
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0855261041C0700X
TX656201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical