Stephanie L Bartz Hudson

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Hebron, IN

NPI 1003535246 · NPPES record last updated Aug 23, 2022

Key facts

NPI
1003535246
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
C2-5197 (IN)
Practice address
617 Persimmon Pkwy
Hebron, IN 46341-8621
Phone
(219) 508-1964
NPI assigned
Aug 23, 2022
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
C2-5197INMDAddiction (Substance Use Disorder) Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X C2-5197 IN Yes

Addresses

Primary practice location

617 Persimmon Pkwy
Hebron, IN 46341-8621

Mailing address

617 Persimmon Pkwy
Hebron, IN 46341-8621
Phone (219) 508-1964

Other providers in Hebron, IN

All providers in Hebron, IN · Addiction (Substance Use Disorder) Counselor in Indiana

Sources for this page

Verify at the official NPI Registry.