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Contact Information

CLIFTON R. HUDSON, PH.D.
1335 VIRGINIA ST E
CHARLESTON, WV25301-3011
 Phone: 800-983-2875
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Forensic

103TF0200X 62 Psychologist, Clinical
 

Clinical

103TC0700X 62 Psychologist, Clinical
 

Psychologist

103T00000X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for CLIFTON R. HUDSON, PH.D.

NPI # 1194261123
LBN Legal business name CLIFTON R. HUDSON, PH.D.
Authorized official CLIFTON HUDSON - (SOLE PROPRIETOR)
Entity Organization
Organization subpart 1 No
Enumeration date 01/14/2017
Last updated 01/14/2017 - About 9 years ago
Identifiers
WV License # 908
WV Medicaid 3810002673
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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