Provider Demographics
NPI:1790355535
Name:HUDSON, BRANDY ALLENA (LPC)
Entity Type:Individual
Prefix:
First Name:BRANDY
Middle Name:ALLENA
Last Name:HUDSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:BRANDY
Other - Middle Name:ALLENA
Other - Last Name:MOTTLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2916 HADDINGTON CT
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23224-5716
Mailing Address - Country:US
Mailing Address - Phone:804-304-7434
Mailing Address - Fax:
Practice Address - Street 1:2916 HADDINGTON CT
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23224-5716
Practice Address - Country:US
Practice Address - Phone:804-304-7434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-24
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701010087101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional