Provider Demographics
NPI:1225579535
Name:HOGUE, MARY HELEN (LCSW)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:HELEN
Last Name:HOGUE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6661 SILVERSTREAM AVENUE
Mailing Address - Street 2:UNIT 2077 BUILDING 14
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89107
Mailing Address - Country:US
Mailing Address - Phone:513-501-3751
Mailing Address - Fax:702-921-0575
Practice Address - Street 1:9205 W RUSSELL ROAD
Practice Address - Street 2:BUILDING 3 SUITE 240
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148
Practice Address - Country:US
Practice Address - Phone:702-793-4512
Practice Address - Fax:702-921-0575
Is Sole Proprietor?:No
Enumeration Date:2017-03-20
Last Update Date:2019-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV7530-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical