Healthcare Provider Details

I. General information

NPI: 1245937317
Provider Name (Legal Business Name): JEMETRIAS HUDSON LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2023
Last Update Date: 08/15/2025
Certification Date: 08/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 MORGAN ST STE B
MOUNT PLEASANT TX
75455-5600
US

IV. Provider business mailing address

425 N HIGHLAND AVE STE 260
SHERMAN TX
75092-7377
US

V. Phone/Fax

Practice location:
  • Phone: 903-563-5568
  • Fax: 877-415-3699
Mailing address:
  • Phone: 903-957-0082
  • Fax: 903-957-0351

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number109292
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: