Provider Demographics
NPI:1518221795
Name:HUGHLEY, PHILANDRYA D (MSED, ALC)
Entity Type:Individual
Prefix:
First Name:PHILANDRYA
Middle Name:D
Last Name:HUGHLEY
Suffix:
Gender:F
Credentials:MSED, ALC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 HUGHES RD UNIT 301
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-6513
Mailing Address - Country:US
Mailing Address - Phone:256-640-2312
Mailing Address - Fax:
Practice Address - Street 1:201 WATER HILL RD APT C2
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-2916
Practice Address - Country:US
Practice Address - Phone:256-640-2312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-02
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
ALC4052A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker