Individual provider Active NPI

Carlotta Z Hudson, LPC

  • Professional Counselor
  • Albany, GA
National Provider Identifier
1295487510
Registry record updated Jan 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC012625 Issued in GA
Practice address
1309 10TH Ave
Albany, GA 31707-3532
Phone
(229) 485-6599
Fax
(229) 207-7542
NPI assigned
Jan 19, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC012625 GA Primary

Addresses

Primary practice location

1309 10TH Ave
Albany, GA 31707-3532

Mailing address

1309 10TH Ave
Albany, GA 31707-3532
Phone (229) 485-6599

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240522002575 GA Practitioner - Mental Health Counselor 9739521758 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lifesource of North CarolinaGroup PAC ID 7416132428, 172 clinicians

Practice addresses (Care Compare)

1345 Redmond Cir NW
Rome, GA 30165-1307
Phone (910) 742-9243

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lifesource of North Carolina CurrentSince May 17, 2024 Accepting new patients
Lifesource of North Carolina CurrentSince May 17, 2024 Accepting new patients

Locations

1345 Redmond Cir NW
Rome, GA 30165
Phone (706) 234-8281

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1642550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642550400000",
    "number": "1295487510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1309 10TH AVE",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317073532",
            "telephone_number": "229-485-6599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 10TH AVE",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317073532",
            "telephone_number": "229-485-6599",
            "fax_number": "229-207-7542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "CARLOTTA",
        "middle_name": "Z",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-19",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC012625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, GA

Sources for this page

Verify at the official NPI Registry.