Provider Demographics
NPI:1467831677
Name:HUGHES, ALYSA ELIZABETH (LPC, RPT)
Entity Type:Individual
Prefix:
First Name:ALYSA
Middle Name:ELIZABETH
Last Name:HUGHES
Suffix:
Gender:F
Credentials:LPC, RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2458 WHITEOAK RUN
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080
Mailing Address - Country:US
Mailing Address - Phone:678-908-9440
Mailing Address - Fax:
Practice Address - Street 1:3193 HOWELL MILL RD
Practice Address - Street 2:SUITE 225
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327
Practice Address - Country:US
Practice Address - Phone:770-293-1950
Practice Address - Fax:770-293-1953
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-20
Last Update Date:2019-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC010099101YP2500X
GAAPC004592101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty