Provider Demographics
NPI:1144034125
Name:HUTSON, KAI ELIZABETH (LMHC)
Entity type:Individual
Prefix:
First Name:KAI
Middle Name:ELIZABETH
Last Name:HUTSON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 SPRING TIDE WAY
Mailing Address - Street 2:
Mailing Address - City:PONTE VEDRA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32081-4417
Mailing Address - Country:US
Mailing Address - Phone:904-652-9332
Mailing Address - Fax:
Practice Address - Street 1:131 SPRING TIDE WAY
Practice Address - Street 2:
Practice Address - City:PONTE VEDRA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32081-4417
Practice Address - Country:US
Practice Address - Phone:904-652-9332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-01
Last Update Date:2025-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH23624101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health