Individual provider Active NPI

Nicole Ann Hudgens, LCPC

  • Counselor
  • Marion, IL
National Provider Identifier
1508181264
Registry record updated May 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
180.004892 Issued in IL
Practice address
1307 W Main St
Marion, IL 62959-1139
Phone
(618) 997-5336
Fax
(618) 993-2969
NPI assigned
Apr 6, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 180.004892 IL Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 180.004892 IL
Mental Health Counselor 101YM0800X 180.004892 IL

Addresses

Primary practice location

1307 W Main St
Marion, IL 62959-1139

Mailing address

9604 Herrin Rd
Johnston City, IL 62951-2523
Phone (618) 997-5336

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
180.004892ILMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1270512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273536000000",
    "number": "1508181264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9604 HERRIN RD",
            "city": "JOHNSTON CITY",
            "state": "IL",
            "postal_code": "629512523",
            "telephone_number": "618-997-5336",
            "fax_number": "618-993-2969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1307 W MAIN ST",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629591139",
            "telephone_number": "618-997-5336",
            "fax_number": "618-993-2969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDGENS",
        "first_name": "NICOLE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-06",
        "last_updated": "2010-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "180.004892",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "180.004892",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180.004892",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2010; 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.