Provider Demographics
NPI:1386111631
Name:HUDAK, JILL (LPC, ATR)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:HUDAK
Suffix:
Gender:F
Credentials:LPC, ATR
Other - Prefix:
Other - First Name:JILL
Other - Middle Name:
Other - Last Name:SABO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LLPC, ATR
Mailing Address - Street 1:4000 W WALTON BLVD STE A-B
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48329-4191
Mailing Address - Country:US
Mailing Address - Phone:248-461-6266
Mailing Address - Fax:
Practice Address - Street 1:4000 W WALTON BLVD STE A-B
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48329-4191
Practice Address - Country:US
Practice Address - Phone:248-461-6266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-25
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health