Provider Demographics
NPI:1093700601
Name:HUDSON, LEIGH ANNE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LEIGH
Middle Name:ANNE
Last Name:HUDSON
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 1:1501 N UNIVERSITY AVE STE 412
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72207-5295
Mailing Address - Country:US
Mailing Address - Phone:501-295-6385
Mailing Address - Fax:501-399-0781
Practice Address - Street 1:1501 N UNIVERSITY AVE STE 412
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72207-5295
Practice Address - Country:US
Practice Address - Phone:501-295-6385
Practice Address - Fax:501-377-9081
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-20
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1817-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5Y206Medicare ID - Type Unspecified