Provider Demographics
NPI:1497799316
Name:HUDSON, ROLAND BANKS III (LMFT)
Entity Type:Individual
Prefix:MR
First Name:ROLAND
Middle Name:BANKS
Last Name:HUDSON
Suffix:III
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 WIND HAVEN DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:NICHOLASVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40356-8035
Mailing Address - Country:US
Mailing Address - Phone:859-277-0255
Mailing Address - Fax:859-277-0077
Practice Address - Street 1:101 WIND HAVEN DR
Practice Address - Street 2:SUITE 202
Practice Address - City:NICHOLASVILLE
Practice Address - State:KY
Practice Address - Zip Code:40356-8035
Practice Address - Country:US
Practice Address - Phone:859-277-0255
Practice Address - Fax:859-277-0077
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0029106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist