Individual provider Active NPI

Jessica Hudson

  • Behavior Analyst
  • Charleston, SC
National Provider Identifier
1083207534
Registry record updated Feb 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-21-47019 Issued in SC
Practice address
1529 Sam Rittenberg Blvd Ste 1B
Charleston, SC 29407-4125
Phone
(888) 547-2250
NPI assigned
Feb 16, 2021
Last updated
Feb 16, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-21-47019 SC Primary

Addresses

Primary practice location

1529 Sam Rittenberg Blvd Ste 1B
Charleston, SC 29407-4125

Mailing address

1483 Cambridge Lakes Dr
Mount Pleasant, SC 29464-7301
Phone (803) 497-2511

Other names 1

  • Jessica Lauren Brown Hudson Other name

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Unumb Center for Neurodevelopment Current Accepting new patients
The Unumb Center for Neurodevelopment Behavior Analyst Current Accepting new patients
Carolina Behavioral Specialists, LLC Behavior Analyst PastSince Feb 21, 2021 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1613433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613433600000",
    "number": "1083207534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1483 CAMBRIDGE LAKES DR",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294647301",
            "telephone_number": "803-497-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1529 SAM RITTENBERG BLVD STE 1B",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294074125",
            "telephone_number": "888-547-2250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-16",
        "last_updated": "2021-02-16",
        "certification_date": "2021-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "SC",
            "license": "1-21-47019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "HUDSON",
            "middle_name": "LAUREN BROWN",
            "credential": "MA, BCBA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.