Individual
MR. DAMASO ALLEN HODGES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1639 W FOSTER AVE APT 2, CHICAGO, IL 60640-2086
(330) 280-3032
Mailing address
1996 APACHE TRL, ROUND LAKE BEACH, IL 60073-1365
(330) 280-3032
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
150101823
IL
1041C0700X
Clinical Social Worker
Primary
149021755
IL
252Y00000X
Early Intervention Provider Agency
—
—
Other
Enumeration date
03/01/2012
Last updated
11/20/2019
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