Individual provider Active NPI

Joshua Hudson

  • Clinical Social Worker
  • Coraopolis, PA
National Provider Identifier
1659989366
Registry record updated May 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW130668 Issued in PA
Practice address
Director Psychological Health 911TH Airlift Wing
2745 Defense Ave
Coraopolis, PA 15108
Phone
(412) 474-8813
NPI assigned
Jul 20, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CW021986 PA
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 112509 AK
Clinical Social Worker 1041C0700X SW130668 PA Primary

Addresses

Primary practice location

Director Psychological Health 911TH Airlift Wing
2745 Defense Ave
Coraopolis, PA 15108

Mailing address

2745 Defense Ave
Coraopolis, PA 15108
Phone (412) 474-8813

Other practice location 1

736 Ravenswood Ave
Pittsburgh, PA 15202-1140
Phone (412) 433-0407

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
112509AKMDClinical Social Worker
CW021986PAMDClinical Social Worker
SW130668PAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1595203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652918400000",
    "number": "1659989366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2745 DEFENSE AVE",
            "city": "CORAOPOLIS",
            "state": "PA",
            "postal_code": "15108",
            "telephone_number": "412-474-8813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DIRECTOR PSYCHOLOGICAL HEALTH 911TH AIRLIFT WING",
            "address_2": "2745 DEFENSE AVE",
            "city": "CORAOPOLIS",
            "state": "PA",
            "postal_code": "15108",
            "telephone_number": "412-474-8813"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "736 Ravenswood Ave",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152021140",
            "country_code": "US",
            "telephone_number": "412-433-0407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "JOSHUA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-07-20",
        "last_updated": "2022-05-19",
        "certification_date": "2022-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW021986",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "AK",
            "license": "112509",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "SW130668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coraopolis, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2022; 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.