Individual provider Active NPI

Paula Bernice Hudson, LCSW ACSW

  • Clinical Social Worker
  • Hopkinsville, KY
National Provider Identifier
1992770721
Registry record updated Nov 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1014KY Issued in KY
Practice address
2675 Greenville Road
Hopkinsville, KY 42241-4074
Phone
(270) 188-9125
Fax
(270) 881-1100
NPI assigned
Feb 23, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 1014KY KY Primary
Clinical Social Worker 1041C0700X KY1014 KY

Addresses

Primary practice location

2675 Greenville Road
Hopkinsville, KY 42241-4074

Mailing address

2675 Greenville Road PO Box 4074
Hopkinsville, KY 42241-4074
Phone (270) 188-9125

Other identifiers 1

IdentifierTypeStateIssuer
7100426660MedicaidKY

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
1014KYKYMDClinical Social Worker
KY1014KYMDClinical Social Worker
1014KYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574380800000",
    "number": "1992770721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 GREENVILLE ROAD PO BOX 4074",
            "city": "HOPKINSVILLE",
            "state": "KY",
            "postal_code": "422414074",
            "telephone_number": "270-188-9125",
            "fax_number": "270-881-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2675 GREENVILLE ROAD",
            "city": "HOPKINSVILLE",
            "state": "KY",
            "postal_code": "422414074",
            "telephone_number": "270-188-9125",
            "fax_number": "270-881-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "PAULA",
        "middle_name": "BERNICE",
        "name_prefix": "Ms.",
        "credential": "LCSW ACSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-23",
        "last_updated": "2019-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "1014KY",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "KY1014",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100426660",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hopkinsville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2019; 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.