Provider Demographics
NPI:1992126767
Name:ANNA M HUDAK, MSW LCSW
Entity type:Organization
Organization Name:ANNA M HUDAK, MSW LCSW
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:HUDAK
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:908-419-4721
Mailing Address - Street 1:1010 ROUTE 71 STE 2
Mailing Address - Street 2:
Mailing Address - City:SPRING LAKE
Mailing Address - State:NJ
Mailing Address - Zip Code:07762-3223
Mailing Address - Country:US
Mailing Address - Phone:732-338-9242
Mailing Address - Fax:732-280-8514
Practice Address - Street 1:1010 ROUTE 71
Practice Address - Street 2:UNIT 202
Practice Address - City:SPRING LAKE
Practice Address - State:NJ
Practice Address - Zip Code:07762-3222
Practice Address - Country:US
Practice Address - Phone:908-419-4722
Practice Address - Fax:732-280-8514
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-21
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC05304400251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health