Provider Demographics
NPI:1568734259
Name:HUDAK, LOUISE MOYE (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:LOUISE
Middle Name:MOYE
Last Name:HUDAK
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 CARDINAL DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-8909
Mailing Address - Country:US
Mailing Address - Phone:252-624-3064
Mailing Address - Fax:508-433-1871
Practice Address - Street 1:610 LYNNDALE CT
Practice Address - Street 2:STE D
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-5400
Practice Address - Country:US
Practice Address - Phone:252-624-3064
Practice Address - Fax:508-433-1871
Is Sole Proprietor?:No
Enumeration Date:2012-01-27
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0085981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical