Provider Demographics
NPI:1295811354
Name:HUDSON, LINDA B (LCSW)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:B
Last Name:HUDSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 N CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37130-3636
Mailing Address - Country:US
Mailing Address - Phone:615-278-2241
Mailing Address - Fax:615-904-9182
Practice Address - Street 1:420 BELL AVE
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37405-3404
Practice Address - Country:US
Practice Address - Phone:423-756-2740
Practice Address - Fax:423-870-4170
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3789104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3920768Medicare ID - Type Unspecified