MEDICARE: MEGHAN C HUDSON LPCMH

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	101YM0800X	Mental Health Counselor	PC-0000828	DE

General Provider Information

NPI Number	:	1508376195
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGHAN C HUDSON LPCMH

Provider Business Mailing Address
First Line	:	200 HYGEIA DR
Second Line	:
City	:	NEWARK
State	:	DE
Zip	:	19713-2049
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 S MAIN ST STE 207
Second Line	:
City	:	SMYRNA
State	:	DE
Zip	:	19977-1479
Country	:	US
Telephone Number	:	302-659-4520
Fax Number	:

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

Provider Enumeration Date	:	10/09/2017
Last Update Date	:	12/27/2023

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