Provider Demographics
NPI:1366536971
Name:HUDGENS SPEARS, CHARI LEA (LMFT,LADAC)
Entity type:Individual
Prefix:
First Name:CHARI
Middle Name:LEA
Last Name:HUDGENS SPEARS
Suffix:
Gender:F
Credentials:LMFT,LADAC
Other - Prefix:
Other - First Name:CHARI
Other - Middle Name:
Other - Last Name:SPEARS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:900 MARSHALL
Mailing Address - Street 2:
Mailing Address - City:TRUTH OR CONSEQUENCES
Mailing Address - State:NM
Mailing Address - Zip Code:87901
Mailing Address - Country:US
Mailing Address - Phone:505-894-0066
Mailing Address - Fax:
Practice Address - Street 1:900 MARSHALL
Practice Address - Street 2:
Practice Address - City:TRUTH OR CONSEQUENCES
Practice Address - State:NM
Practice Address - Zip Code:87901
Practice Address - Country:US
Practice Address - Phone:505-894-0066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0069571101YA0400X
NM006183106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM00JD67OtherBCBS
NM81129211Medicaid
NMNM101432OtherVALUE OPTIONS