Individual provider Active NPI

David Hudak, LCSW-C

  • Clinical Social Worker
  • Frederick, MD
National Provider Identifier
1477557205
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
04599 Issued in MD
Practice address
170 Thomas Johnson Dr
Ste 200
Frederick, MD 21702-6200
Phone
(301) 695-8390
Fax
(301) 694-7906
NPI assigned
Jun 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 04599 MD Primary

Addresses

Primary practice location

170 Thomas Johnson Dr
Ste 200
Frederick, MD 21702-6200

Mailing address

170 Thomas Johnson Dr
Ste 200
Frederick, MD 21702-6200
Phone (301) 695-8390

Other identifiers 1

IdentifierTypeStateIssuer
512158OtherMDMAMSI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jan 1, 2014 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
04599MDMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Ridge Behavioral Health Services, LLC Clinical PastSince Jan 12, 2009 Accepting new patients

Organizations & group practices 1

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": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1477557205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 THOMAS JOHNSON DR",
            "address_2": "STE 200",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217026200",
            "telephone_number": "301-695-8390",
            "fax_number": "301-694-7906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 THOMAS JOHNSON DR",
            "address_2": "STE 200",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217026200",
            "telephone_number": "301-695-8390",
            "fax_number": "301-694-7906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDAK",
        "first_name": "DAVID",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "04599",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "512158",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.