Provider Demographics
NPI:1437763174
Name:HUGHES, MAISY (LMFT)
Entity Type:Individual
Prefix:
First Name:MAISY
Middle Name:
Last Name:HUGHES
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:828 N STILLMAN ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19130-1836
Mailing Address - Country:US
Mailing Address - Phone:215-359-8593
Mailing Address - Fax:
Practice Address - Street 1:1800 JOHN F KENNEDY BLVD STE 1406
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-7437
Practice Address - Country:US
Practice Address - Phone:215-804-9165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-01
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37FI00214100106H00000X
PAMF001030106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMF001030OtherMARRIAGE AND FAMILY THERAPY LICENSE