Provider Demographics
NPI:1538559661
Name:GADSON, CHUDNEY (LPC-I)
Entity type:Individual
Prefix:
First Name:CHUDNEY
Middle Name:
Last Name:GADSON
Suffix:
Gender:F
Credentials:LPC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 W MAIN ST STE G6
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-2672
Mailing Address - Country:US
Mailing Address - Phone:803-403-1343
Mailing Address - Fax:
Practice Address - Street 1:203 W MAIN ST STE G6
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-2672
Practice Address - Country:US
Practice Address - Phone:803-403-1343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-27
Last Update Date:2015-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5878101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor