Provider Demographics
NPI:1235619875
Name:HUDSON, JENNY LYNN (LPC-MHSP)
Entity Type:Individual
Prefix:
First Name:JENNY
Middle Name:LYNN
Last Name:HUDSON
Suffix:
Gender:F
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4444 IRONHORSE WAY
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37040-5457
Mailing Address - Country:US
Mailing Address - Phone:517-425-2553
Mailing Address - Fax:
Practice Address - Street 1:2219 LOWES DR W
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37040-6888
Practice Address - Country:US
Practice Address - Phone:931-614-7397
Practice Address - Fax:931-443-0079
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-14
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4424101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health