Provider Demographics
NPI:1831448729
Name:HUDSON-PARKER, HAZEL J (LCSW-C)
Entity type:Individual
Prefix:MRS
First Name:HAZEL
Middle Name:J
Last Name:HUDSON-PARKER
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4615 SANDWOOD ROAD
Mailing Address - Street 2:
Mailing Address - City:SPARROWS POINT
Mailing Address - State:MD
Mailing Address - Zip Code:21219
Mailing Address - Country:US
Mailing Address - Phone:443-242-7734
Mailing Address - Fax:
Practice Address - Street 1:4615 SANDWOOD RD
Practice Address - Street 2:
Practice Address - City:SPARROWS POINT
Practice Address - State:MD
Practice Address - Zip Code:21219-2371
Practice Address - Country:US
Practice Address - Phone:443-570-3537
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-06
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD182501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD336116100Medicaid