Provider Demographics
NPI:1578723409
Name:HUD, JIHAD ALEEM (PHD, LCSW)
Entity Type:Individual
Prefix:DR
First Name:JIHAD
Middle Name:ALEEM
Last Name:HUD
Suffix:
Gender:M
Credentials:PHD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2833 MIMOSA ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31906-2163
Mailing Address - Country:US
Mailing Address - Phone:706-221-4830
Mailing Address - Fax:706-622-3030
Practice Address - Street 1:2222 FRANCIS ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31906-2512
Practice Address - Country:US
Practice Address - Phone:706-221-4830
Practice Address - Fax:706-622-3030
Is Sole Proprietor?:No
Enumeration Date:2008-06-13
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0007761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA514073675AMedicaid