John Lawrence Hudak, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

01883 Issued in MD

Practice address

19500 Club House Rd
Montgomery Village, MD 20886-3002

Phone

(301) 990-7591

Fax

(301) 977-9319

NPI assigned

Apr 3, 2007

Sex

Male

Sole proprietor

Yes

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.

• Anne M Menotti, PH.D.LLC

  • Clinical Psychologist
  • Montgomery Village, MD
  • NPI 1811330194
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801917232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19500 CLUB HOUSE RD",
            "city": "MONTGOMERY VILLAGE",
            "state": "MD",
            "postal_code": "208863002",
            "telephone_number": "301-990-7591",
            "fax_number": "301-977-9319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19500 CLUB HOUSE RD",
            "city": "MONTGOMERY VILLAGE",
            "state": "MD",
            "postal_code": "208863002",
            "telephone_number": "301-990-7591",
            "fax_number": "301-977-9319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDAK",
        "first_name": "JOHN",
        "middle_name": "LAWRENCE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MD",
            "license": "01883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Montgomery Village, MD
• Psychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.