Provider Demographics
NPI:1417464769
Name:HUGHES, TONI (LICSW)
Entity Type:Individual
Prefix:
First Name:TONI
Middle Name:
Last Name:HUGHES
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17110 NE 45TH ST APT 28
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-5633
Mailing Address - Country:US
Mailing Address - Phone:910-599-1764
Mailing Address - Fax:
Practice Address - Street 1:10634 E RIVERSIDE DR STE 130
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-3758
Practice Address - Country:US
Practice Address - Phone:910-599-1764
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-09
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW612301671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2117983Medicaid