Kristen Anne Hudacek, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY7334 Issued in FL

Practice address

4720 Cleveland Heights Blvd
Suite 105
Lakeland, FL 33813-2243

Phone

(863) 701-9292

NPI assigned

May 18, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Kristen a. Hudacek, Psy.D., PLC

  • Community/Behavioral Health Agency
  • Tampa, FL
  • NPI 1538377973
  NPD (past) Authorized official

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198627200000",
    "number": "1366650798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5701 MARINER ST",
            "address_2": "#402",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336093442",
            "telephone_number": "813-610-6007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4720 CLEVELAND HEIGHTS BLVD",
            "address_2": "SUITE 105",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338132243",
            "telephone_number": "863-701-9292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDACEK",
        "first_name": "KRISTEN",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-18",
        "last_updated": "2007-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY7334",
            "primary": true
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "FL",
            "license": "PY 7334",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thane Htun, MD
• Charles S Huang, D.O.
• Forin Huang, PHARMD
• Martha Haynes Hubbard, OTR
• Gerard H. Hubbell, O.D
• Joseph C Hudson-Martin, MS
• Andrew Michael Hudson, FNP-BC
• Megan Marie Hudson, PA-C
• Jason Huffman, D.C.
• Hugh H. Roberts D.C., P.a.

• Clinical Psychologist in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2007; 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.