Jonathan Hudak, LPC, NCC, MA

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2010038924 Issued in MO

Practice address

406 N Spring St Ste 2
Perryville, MO 63775-1912

Phone

(573) 547-8305

Fax

(573) 547-8306

NPI assigned

Nov 17, 2010

Last updated

Sep 5, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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

Specialty

Mental Health Counselor

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Counseling CenterGroup PAC ID 9436142460, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Community Counseling Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Cape Girardeau, MO
  • NPI 1235244757
  Medicare reassignment Care Compare group NPD
• Community Counseling Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Cape Girardeau, MO
  • NPI 1861154130
  NPD (past)
• New Vision Youth and Family Services Inc

  • Professional Counselor
  • Cape Girardeau, MO
  • NPI 1396950614
  NPD (past)

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

{
    "created_epoch": "1289952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725494400000",
    "number": "1871895227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 N SPRING ST STE 2",
            "city": "PERRYVILLE",
            "state": "MO",
            "postal_code": "637751912",
            "telephone_number": "573-547-8305",
            "fax_number": "573-547-8306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 N SPRING ST STE 2",
            "city": "PERRYVILLE",
            "state": "MO",
            "postal_code": "637751912",
            "telephone_number": "573-547-8305",
            "fax_number": "573-547-8306"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "820 Park Dr",
            "address_purpose": "LOCATION",
            "city": "Sainte Genevieve",
            "state": "MO",
            "postal_code": "636701566",
            "country_code": "US",
            "telephone_number": "573-883-7407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUDAK",
        "first_name": "JONATHAN",
        "credential": "LPC, NCC, MA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-17",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2010038924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Renee Hoeckele, DC
• Ronald Allen Hohenadel, D.M.D.
• Brooke Elizabeth Hotop, FNP-C
• Maegyn Huber
• Natalie Huber, DPT
• Joseph David Hutchison, D.D.S.
• Immediate Convenient Care-Perryville, LLC
• Immediate Healthcare, Inc.
• Independence Health System, Inc.
• Katie Marie Isgriggs, BS, HIS

• Professional Counselor in Perryville, MO
• Providers in Perryville, MO by specialty
• Professional Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.