Provider Demographics
NPI:1962492892
Name:HUDGINS, DONNA SUE (MA, LPC, NCACII)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:SUE
Last Name:HUDGINS
Suffix:
Gender:F
Credentials:MA, LPC, NCACII
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:SUE
Other - Last Name:SPEAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC, NCACII
Mailing Address - Street 1:PO BOX 1207
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:CO
Mailing Address - Zip Code:81235-1207
Mailing Address - Country:US
Mailing Address - Phone:970-275-9344
Mailing Address - Fax:970-944-2320
Practice Address - Street 1:700 N. HENSON ST.
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:CO
Practice Address - Zip Code:81235-1207
Practice Address - Country:US
Practice Address - Phone:970-275-9344
Practice Address - Fax:970-944-2320
Is Sole Proprietor?:No
Enumeration Date:2005-10-22
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2456101YM0800X, 101YM0800X
COLPC0002456101YP2500X
NM101821101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM12828831Medicaid
CO139037Medicaid
11584111OtherCAQH