Provider Demographics
NPI:1205848397
Name:HUGHES, KENNETH NEAL (SPE)
Entity Type:Individual
Prefix:
First Name:KENNETH
Middle Name:NEAL
Last Name:HUGHES
Suffix:
Gender:M
Credentials:SPE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 E UNAKA AVE
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37601-4624
Mailing Address - Country:US
Mailing Address - Phone:865-281-1408
Mailing Address - Fax:865-244-3579
Practice Address - Street 1:114 E UNAKA AVE
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601-4624
Practice Address - Country:US
Practice Address - Phone:865-281-1408
Practice Address - Fax:865-244-3579
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1587101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health