Individual provider Active NPI

Carmen Lynn Hudgins, LAC MENTAL HEALTH WO

  • Counselor
  • Monticello, AR
National Provider Identifier
1861509374
Registry record updated Aug 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
A0607041 Issued in AR
Practice address
1371 Highway 278 W
Monticello, AR 71655-9663
Phone
(870) 365-2143
Fax
(870) 365-2145
NPI assigned
Aug 23, 2006
Last updated
Aug 20, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X A0607041 AR Primary

Addresses

Primary practice location

1371 Highway 278 W
Monticello, AR 71655-9663

Mailing address

PO Box 3479
Monticello, AR 71656-3479
Phone (870) 403-6034

Other identifiers 1

IdentifierTypeStateIssuer
145879726MedicaidAR

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
A0607041ARMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219190400000",
    "number": "1861509374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3479",
            "city": "MONTICELLO",
            "state": "AR",
            "postal_code": "716563479",
            "telephone_number": "870-403-6034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1371 HIGHWAY 278 W",
            "city": "MONTICELLO",
            "state": "AR",
            "postal_code": "716559663",
            "telephone_number": "870-365-2143",
            "fax_number": "870-365-2145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDGINS",
        "first_name": "CARMEN",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "LAC MENTAL HEALTH WO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-23",
        "last_updated": "2008-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "AR",
            "license": "A0607041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145879726",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monticello, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2008; 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.