Provider Demographics
NPI:1083853188
Name:HUGHES, THURMAN EDWARD JR (LICDC)
Entity Type:Individual
Prefix:
First Name:THURMAN
Middle Name:EDWARD
Last Name:HUGHES
Suffix:JR
Gender:M
Credentials:LICDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1634 11TH ST
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45662-4526
Mailing Address - Country:US
Mailing Address - Phone:740-354-6685
Mailing Address - Fax:740-354-5061
Practice Address - Street 1:1634 11TH ST
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-4526
Practice Address - Country:US
Practice Address - Phone:740-354-6685
Practice Address - Fax:740-354-5061
Is Sole Proprietor?:No
Enumeration Date:2009-02-12
Last Update Date:2009-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH913019101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)