Provider Demographics
NPI:1982019154
Name:HUDSON, MELYNDA NORTON
Entity Type:Individual
Prefix:
First Name:MELYNDA
Middle Name:NORTON
Last Name:HUDSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MELYNDA
Other - Middle Name:KAYE
Other - Last Name:NORTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC, NCC
Mailing Address - Street 1:6522 CAMP BULLIS RD
Mailing Address - Street 2:APT 1201
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78256-2340
Mailing Address - Country:US
Mailing Address - Phone:210-232-0650
Mailing Address - Fax:
Practice Address - Street 1:6522 CAMP BULLIS RD
Practice Address - Street 2:APT 1201
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78256-2340
Practice Address - Country:US
Practice Address - Phone:210-232-0650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-26
Last Update Date:2014-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC284295101YM0800X
TX68137101YP2500X
TX101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool