| Jennifer Hodgson Clinical Services Llc | |
|
2207 E 5th St Superior WI 54880-3708 | |
| (218) 409-8114 | |
| (218) 234-2993 |
| Full Name | Jennifer Hodgson Clinical Services Llc |
|---|---|
| Speciality | Counselor |
| Location | 2207 E 5th St, Superior, Wisconsin |
| Authorized Official Name and Position | Jennifer Hodgson (LPC/OWNER) |
| Authorized Official Contact | 2184098114 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jennifer Hodgson Clinical Services Llc 61320 W Fork Rd Iron River WI 54847-2600 Ph: (218) 409-8114 | Jennifer Hodgson Clinical Services Llc 2207 E 5th St Superior WI 54880-3708 Ph: (218) 409-8114 |
| NPI Number | 1649091356 |
|---|---|
| Provider Enumeration Date | 10/24/2024 |
| Last Update Date | 10/24/2024 |
| Certification Date | 10/22/2024 |
| Medicare PECOS PAC ID | 1557896404 |
|---|---|
| Medicare Enrollment ID | O20241202000917 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649091356 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Jennifer Hodgson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1578638201 PECOS PAC ID: 1456794270 Enrollment ID: I20240208003397 |
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