Individual provider Active NPI

Charles Thomas Hudak, CADC III

  • Addiction (Substance Use Disorder) Counselor
  • Costa Mesa, CA
National Provider Identifier
1104786995
Registry record updated Nov 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
B00003950425 Issued in CA
Practice address
1640 Superior Ave
Costa Mesa, CA 92627-3652
Phone
(714) 348-6611
NPI assigned
Nov 13, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X B00003950425 CA Primary

Addresses

Primary practice location

1640 Superior Ave
Costa Mesa, CA 92627-3652

Mailing address

1640 Superior Ave
Costa Mesa, CA 92627-3652
Phone (714) 348-6611

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

State licenses

LicenseStateTypeSpecialty
B00003950425CAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1762992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762992000000",
    "number": "1104786995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 SUPERIOR AVE",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926273652",
            "telephone_number": "714-348-6611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 SUPERIOR AVE",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926273652",
            "telephone_number": "714-348-6611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDAK",
        "first_name": "CHARLES",
        "middle_name": "THOMAS",
        "credential": "CADC III",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-11-13",
        "last_updated": "2025-11-13",
        "certification_date": "2025-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "B00003950425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2025; 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.