Provider Demographics
NPI:1366680027
Name:HUGHES, LAWRENCE M (LICSW)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:M
Last Name:HUGHES
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 HIGHLANDS DR
Mailing Address - Street 2:
Mailing Address - City:EASTSOUND
Mailing Address - State:WA
Mailing Address - Zip Code:98245-8909
Mailing Address - Country:US
Mailing Address - Phone:347-244-0507
Mailing Address - Fax:
Practice Address - Street 1:151 HIGHLANDS DR
Practice Address - Street 2:
Practice Address - City:EASTSOUND
Practice Address - State:WA
Practice Address - Zip Code:98245-8909
Practice Address - Country:US
Practice Address - Phone:347-244-0507
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-03
Last Update Date:2014-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW604067281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1366680027Medicare PIN