MEDICARE: PHYLANDRIA LASHAY HUDSON LCSW

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	1041C0700X	Clinical Social Worker	0904017046	VA
2	1041C0700X	Clinical Social Worker	C-5832	MS

General Provider Information

NPI Number	:	1164762076
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHYLANDRIA LASHAY HUDSON LCSW

Provider Business Mailing Address
First Line	:	8221 WILLOW OAKS CORPORATE DR # 4420
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22031-4512
Country	:	US
Telephone Number	:	703-289-7560
Fax Number	:	703-204-9001

Provider Business Practice Location Address
First Line	:	8221 WILLOW OAKS CORPORATE DR # 4420
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22031-4512
Country	:	US
Telephone Number	:	703-289-7560
Fax Number	:	703-204-9001

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

Provider Enumeration Date	:	03/01/2013
Last Update Date	:	04/07/2026

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