Provider Demographics
NPI:1346453875
Name:HOGUE, BAXTER HUGH (LPC)
Entity Type:Individual
Prefix:MR
First Name:BAXTER
Middle Name:HUGH
Last Name:HOGUE
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 1:1855 LAKELAND DR
Mailing Address - Street 2:F-21
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39216-4913
Mailing Address - Country:US
Mailing Address - Phone:601-982-5376
Mailing Address - Fax:601-982-5377
Practice Address - Street 1:1855 LAKELAND DR
Practice Address - Street 2:F-21
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216-4913
Practice Address - Country:US
Practice Address - Phone:601-982-5376
Practice Address - Fax:601-982-5377
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2009-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1093101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor