Individual provider Active NPI

Tiffany Kay Hudak, LCSWC

  • Social Worker
  • Dundalk, MD
National Provider Identifier
1801553615
Registry record updated Jan 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
26476 Issued in MD
Practice address
6502 Baltimore Ave
Dundalk, MD 21222-4001
Phone
(410) 269-3631
NPI assigned
Nov 29, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 26476 MD Primary

Addresses

Primary practice location

6502 Baltimore Ave
Dundalk, MD 21222-4001

Mailing address

6502 Baltimore Ave
Dundalk, MD 21222-4001
Phone (410) 269-3631

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20240604002391 MD Practitioner - Clinical Social Worker 1850833021 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

6502 Baltimore Ave
Dundalk, MD 21222-4001
Phone (410) 269-3631

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26476MDMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Reaching for Resilience LLC CurrentSince Jan 14, 2024 Accepting new patients
Reaching for Resilience LLC CurrentSince Mar 6, 2024 Accepting new patients

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": "1638144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704931200000",
    "number": "1801553615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6502 BALTIMORE AVE",
            "city": "DUNDALK",
            "state": "MD",
            "postal_code": "212224001",
            "telephone_number": "410-269-3631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6502 BALTIMORE AVE",
            "city": "DUNDALK",
            "state": "MD",
            "postal_code": "212224001",
            "telephone_number": "410-269-3631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDAK",
        "first_name": "TIFFANY",
        "middle_name": "KAY",
        "credential": "LCSWC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-29",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MD",
            "license": "26476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dundalk, MD

Sources for this page

Verify at the official NPI Registry.