Provider Demographics
NPI:1558523365
Name:HUGHES, JEREMY (MSW, P-LCSW)
Entity Type:Individual
Prefix:
First Name:JEREMY
Middle Name:
Last Name:HUGHES
Suffix:
Gender:M
Credentials:MSW, P-LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 PEE DEE AVE STE A
Mailing Address - Street 2:
Mailing Address - City:ALBEMARLE
Mailing Address - State:NC
Mailing Address - Zip Code:28001-4945
Mailing Address - Country:US
Mailing Address - Phone:704-986-1500
Mailing Address - Fax:704-983-3919
Practice Address - Street 1:350 PEE DEE AVE STE A
Practice Address - Street 2:
Practice Address - City:ALBEMARLE
Practice Address - State:NC
Practice Address - Zip Code:28001-4945
Practice Address - Country:US
Practice Address - Phone:704-986-1500
Practice Address - Fax:704-983-3919
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-02
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0045211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical