MEDICARE: COURTNEE LATRICE HUDSON LPC

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	62054	TX

General Provider Information

NPI Number	:	1346020401
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COURTNEE LATRICE HUDSON LPC

Provider Business Mailing Address
First Line	:	425 N HIGHLAND AVE STE 260
Second Line	:
City	:	SHERMAN
State	:	TX
Zip	:	75092-7377
Country	:	US
Telephone Number	:	903-957-0082
Fax Number	:	903-957-0351

Provider Business Practice Location Address
First Line	:	2001 BEACH ST STE 530
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76103-2313
Country	:	US
Telephone Number	:	903-957-0082
Fax Number	:	903-957-0351

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

Provider Enumeration Date	:	10/04/2023
Last Update Date	:	05/17/2026

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