Organization
LIFE PATHS COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEATHER M HUDSON LCSW (OWNER)
(812) 361-1234
Entity
Organization
Contact information
Practice address
101 W KIRKWOOD AVE STE 222, BLOOMINGTON, IN 47404-6133
(812) 361-1234
Mailing address
101 W KIRKWOOD AVE STE 222, BLOOMINGTON, IN 47404-6133
(812) 361-1234
(812) 676-9351
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34005660A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
IN1464
MEDICARE PTAN
—
Enumeration date
07/09/2013
Last updated
12/22/2014
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