Provider Demographics
NPI:1558139089
Name:HUGHES, EVAN THOMAS (BS)
Entity Type:Individual
Prefix:
First Name:EVAN
Middle Name:THOMAS
Last Name:HUGHES
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 CAMBRIDGE POINTE
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25309-8596
Mailing Address - Country:US
Mailing Address - Phone:304-552-2249
Mailing Address - Fax:
Practice Address - Street 1:716 LEE ST E
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25301-1707
Practice Address - Country:US
Practice Address - Phone:304-552-2249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-14
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor