Provider Demographics
NPI:1215234893
Name:HUDNALL, KAREN LUCE (MA)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:LUCE
Last Name:HUDNALL
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:
Other - Last Name:LUCE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA
Mailing Address - Street 1:1650 LUCERNE ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:MINDEN
Mailing Address - State:NV
Mailing Address - Zip Code:89423-4345
Mailing Address - Country:US
Mailing Address - Phone:775-781-9582
Mailing Address - Fax:775-783-4200
Practice Address - Street 1:1650 LUCERNE ST
Practice Address - Street 2:SUITE 104
Practice Address - City:MINDEN
Practice Address - State:NV
Practice Address - Zip Code:89423-4345
Practice Address - Country:US
Practice Address - Phone:775-781-9582
Practice Address - Fax:775-783-4200
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-17
Last Update Date:2011-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVL-0410101YA0400X
NVIP1008202101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)