Provider Demographics
NPI:1114629375
Name:HUDSON, HOLLI JO (LPC)
Entity Type:Individual
Prefix:
First Name:HOLLI
Middle Name:JO
Last Name:HUDSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 APPLE ST
Mailing Address - Street 2:
Mailing Address - City:CLEARFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:16830-1717
Mailing Address - Country:US
Mailing Address - Phone:814-762-2144
Mailing Address - Fax:
Practice Address - Street 1:8912 CLEARFIELD CURWENSVILLE HWY
Practice Address - Street 2:
Practice Address - City:CLEARFIELD
Practice Address - State:PA
Practice Address - Zip Code:16830-3520
Practice Address - Country:US
Practice Address - Phone:814-762-2144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-21
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC015384101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional