Provider Demographics
NPI:1952098576
Name:HUDSON, JORDANA B (LPC-A)
Entity Type:Individual
Prefix:PROF
First Name:JORDANA
Middle Name:B
Last Name:HUDSON
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1652 PRESCOTT CIR
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-7305
Mailing Address - Country:US
Mailing Address - Phone:903-819-4576
Mailing Address - Fax:
Practice Address - Street 1:3960 BROADWAY BLVD STE 250
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-8345
Practice Address - Country:US
Practice Address - Phone:214-785-1843
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX90715101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional