Provider Demographics
NPI:1982286795
Name:HUDGINS, HEATHER DIANE (MS, LCADC)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:DIANE
Last Name:HUDGINS
Suffix:
Gender:F
Credentials:MS, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:370 MEMORIAL PKWY
Mailing Address - Street 2:
Mailing Address - City:PHILLIPSBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08865-1580
Mailing Address - Country:US
Mailing Address - Phone:908-454-4470
Mailing Address - Fax:908-454-5317
Practice Address - Street 1:370 MEMORIAL PKWY
Practice Address - Street 2:
Practice Address - City:PHILLIPSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08865-1580
Practice Address - Country:US
Practice Address - Phone:908-454-4470
Practice Address - Fax:908-454-5317
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-22
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00280100101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)