MEDICARE: MRS. SHIRLEY ANN HUDSON MS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	904578	IN
2	101YS0200X	School Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	904578	OTHER	IN	COUNSELOR-PROFESSIONAL
2	904578	OTHER	IN	COUNSELOR SCHOOL

General Provider Information

NPI Number	:	1942442645
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHIRLEY ANN HUDSON MS

Provider Business Mailing Address
First Line	:	3401 N MERIDIAN ST
Second Line	:	SUITE 176
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46208-4436
Country	:	US
Telephone Number	:	317-226-2825
Fax Number	:	317-226-3725

Provider Business Practice Location Address
First Line	:	3401 N MERIDIAN ST
Second Line	:	SUITE 176
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46208-4436
Country	:	US
Telephone Number	:	317-226-2825
Fax Number	:	317-226-3725

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/27/2009
Last Update Date	:	12/14/2025

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