Provider Demographics
NPI:1326574724
Name:HUGHES, TIMOTHY ANDREW (LPC)
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:ANDREW
Last Name:HUGHES
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:263 S HEATH LN
Mailing Address - Street 2:
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83401-4601
Mailing Address - Country:US
Mailing Address - Phone:208-497-2783
Mailing Address - Fax:208-561-7404
Practice Address - Street 1:263 S HEATH LN
Practice Address - Street 2:
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83401-4601
Practice Address - Country:US
Practice Address - Phone:208-497-2783
Practice Address - Fax:208-561-7404
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-04
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178011705101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health