Provider Demographics
NPI:1326402140
Name:HUGHES, WILEY EDGAR (LCMHC, PSYD, DMIN)
Entity Type:Individual
Prefix:DR
First Name:WILEY
Middle Name:EDGAR
Last Name:HUGHES
Suffix:
Gender:M
Credentials:LCMHC, PSYD, DMIN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6405 CAMDEN RD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28306-7216
Mailing Address - Country:US
Mailing Address - Phone:910-835-6653
Mailing Address - Fax:910-425-0013
Practice Address - Street 1:6405 CAMDEN RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28306-7216
Practice Address - Country:US
Practice Address - Phone:910-835-6653
Practice Address - Fax:910-425-0013
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-07
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13990101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health