NPIMap

Organization Active NPI

Clifton R. Hudson, PH.D.

  • Forensic Psychologist
  • Charleston, WV
National Provider Identifier
1194261123
Registry record updated Jan 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Forensic PsychologistTaxonomy code 103TF0200X
License
908 Issued in WV
Legal business name
CLIFTON R. HUDSON, PH.D.
Practice address
1335 Virginia St E
Charleston, WV 25301-3011
Phone
(800) 983-2875
NPI assigned
Jan 14, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2017

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

Authorized official

Name
Dr. Clifton Robert Hudson, PH.D.NPI 1962413567
Title
Sole Proprietor
Phone
(800) 983-2875

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X 908 WV
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 908 WV
Forensic PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TF0200X 908 WV Primary

Addresses

Primary practice location

1335 Virginia St E
Charleston, WV 25301-3011

Mailing address

1335 Virginia St E
Charleston, WV 25301-3011

Other identifiers 1

IdentifierTypeStateIssuer
3810002673MedicaidWV

Other names 1

  • Hudson Forensic Psychology Doing business as

National Provider Directory

National Provider Directory

Locations

1335 Virginia St E
Charleston, WV 25301
Phone (800) 983-2875

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1484352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484352000000",
    "number": "1194261123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1335 VIRGINIA ST E",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253013011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1335 VIRGINIA ST E",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253013011",
            "telephone_number": "800-983-2875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLIFTON R. HUDSON, PH.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-14",
        "last_updated": "2017-01-14",
        "status": "A",
        "authorized_official_last_name": "HUDSON",
        "authorized_official_first_name": "CLIFTON",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "800-983-2875",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "WV",
            "license": "908",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "WV",
            "license": "908",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Forensic",
            "state": "WV",
            "license": "908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810002673",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hudson Forensic Psychology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charleston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2017; 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.