Provider Demographics
NPI:1235679705
Name:HUDSON, JOE JR (CAP)
Entity Type:Individual
Prefix:
First Name:JOE
Middle Name:
Last Name:HUDSON
Suffix:JR
Gender:M
Credentials:CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9723 ACQUA CT UNIT 312
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34113-8141
Mailing Address - Country:US
Mailing Address - Phone:239-776-4318
Mailing Address - Fax:
Practice Address - Street 1:235 AIRPORT RD S
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34104-3510
Practice Address - Country:US
Practice Address - Phone:239-227-2839
Practice Address - Fax:239-465-0639
Is Sole Proprietor?:No
Enumeration Date:2017-03-03
Last Update Date:2017-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCAP 1051101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)