Provider Demographics
NPI:1780955732
Name:HUDKINS, JENA MARIE (LMSW)
Entity type:Individual
Prefix:
First Name:JENA
Middle Name:MARIE
Last Name:HUDKINS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:JENA
Other - Middle Name:MARIE
Other - Last Name:HOOVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSW
Mailing Address - Street 1:324 EMERSON RD
Mailing Address - Street 2:
Mailing Address - City:HIGH RIDGE
Mailing Address - State:MO
Mailing Address - Zip Code:63049
Mailing Address - Country:US
Mailing Address - Phone:636-535-3753
Mailing Address - Fax:
Practice Address - Street 1:324 EMERSON RD
Practice Address - Street 2:
Practice Address - City:HIGH RIDGE
Practice Address - State:MO
Practice Address - Zip Code:63049
Practice Address - Country:US
Practice Address - Phone:636-535-3753
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-23
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20220147721041C0700X
MO20190222454104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical