Active NPI
Kristen Hudson
- Behavior Analyst
- Henderson, KY
National Provider Identifier
1932404035
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1000
- Practice address
- 1040 Market St
Henderson, KY 42420-4855 - Phone
- (270) 827-4652
- Fax
- (270) 831-1182
- NPI assigned
- Jan 20, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | |||
| Behavior Analyst | 103K00000X | 1000 | KY | Primary |
Addresses
Primary practice location
1040 Market St
Henderson, KY 42420-4855
Mailing address
1040 Market St
Henderson, KY 42420-4855
Phone (270) 827-4652
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7100215710 | Medicaid | KY | |
| 7100174590 | Other | KY | SCL WAIVER |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1000 | KY | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Growing Minds Learning Center, LLC | Behavior Analyst | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Surpass Behavioral Health
- Behavior Analyst
- Bowling Green, KY
- NPI 1275813222
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1295481600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383609600000",
"number": "1932404035",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1040 MARKET ST",
"city": "HENDERSON",
"state": "KY",
"postal_code": "424204855",
"telephone_number": "270-827-4652",
"fax_number": "270-831-1182"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1040 MARKET ST",
"city": "HENDERSON",
"state": "KY",
"postal_code": "424204855",
"telephone_number": "270-827-4652",
"fax_number": "270-831-1182"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUDSON",
"first_name": "KRISTEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-01-20",
"last_updated": "2013-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "KY",
"license": "1000",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7100215710",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SCL WAIVER",
"identifier": "7100174590",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Henderson, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.