Provider Demographics
NPI:1750729513
Name:HUDSON, JOSIE (LPCMH)
Entity type:Individual
Prefix:
First Name:JOSIE
Middle Name:
Last Name:HUDSON
Suffix:
Gender:F
Credentials:LPCMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5618 KIRKWOOD HWY
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-5004
Mailing Address - Country:US
Mailing Address - Phone:302-998-5618
Mailing Address - Fax:302-998-2497
Practice Address - Street 1:5618 KIRKWOOD HWY
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-5004
Practice Address - Country:US
Practice Address - Phone:302-998-5618
Practice Address - Fax:302-998-2497
Is Sole Proprietor?:No
Enumeration Date:2013-06-13
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEPC-0000638101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor