Provider Demographics
NPI:1881026458
Name:HUDSON, JENNIFER A (MSW, LCSW, LCADC)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:A
Last Name:HUDSON
Suffix:
Gender:F
Credentials:MSW, LCSW, LCADC
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:A
Other - Last Name:DECKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LCSW, LCADC
Mailing Address - Street 1:671 HOES LN W
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-8021
Mailing Address - Country:US
Mailing Address - Phone:732-235-5700
Mailing Address - Fax:
Practice Address - Street 1:671 HOES LN W
Practice Address - Street 2:
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854-8021
Practice Address - Country:US
Practice Address - Phone:646-369-0616
Practice Address - Fax:732-235-5700
Is Sole Proprietor?:No
Enumeration Date:2013-08-06
Last Update Date:2017-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00220500101YA0400X
TN62591041C0700X
MSC89001041C0700X
NJ44SC056163001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4144007Medicaid
NJ31-4011OtherMEDICARE