Provider Demographics
NPI:1417477969
Name:HUGHES, LEA ANNA (LCSW)
Entity Type:Individual
Prefix:
First Name:LEA
Middle Name:ANNA
Last Name:HUGHES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1715 S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58701-6304
Mailing Address - Country:US
Mailing Address - Phone:701-355-6800
Mailing Address - Fax:
Practice Address - Street 1:1715 S BROADWAY
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58701-6304
Practice Address - Country:US
Practice Address - Phone:701-355-6800
Practice Address - Fax:701-838-7515
Is Sole Proprietor?:No
Enumeration Date:2017-06-26
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
ND58301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator