Provider Demographics
NPI:1326012287
Name:HUBBARD, NORMAN DAVID (LMHC)
Entity Type:Individual
Prefix:MR
First Name:NORMAN
Middle Name:DAVID
Last Name:HUBBARD
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:MR
Other - First Name:N
Other - Middle Name:DAVID
Other - Last Name:HUBBARD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHC
Mailing Address - Street 1:4591 E HIGHWAY 20
Mailing Address - Street 2:
Mailing Address - City:NICEVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32578-8844
Mailing Address - Country:US
Mailing Address - Phone:850-279-6958
Mailing Address - Fax:850-279-0999
Practice Address - Street 1:4591 E HIGHWAY 20
Practice Address - Street 2:
Practice Address - City:NICEVILLE
Practice Address - State:FL
Practice Address - Zip Code:32578-8844
Practice Address - Country:US
Practice Address - Phone:850-279-6958
Practice Address - Fax:850-279-0999
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2012-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 2194101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLN/AOtherTRICARE
FL2061881OtherCIGNA
FL761807700OtherCHILDREN MEDICAL SERVICES
FL761807700Medicaid