Provider Demographics
NPI:1568248011
Name:HUGHES, TIMOTHY B (MED, LPC)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:B
Last Name:HUGHES
Suffix:
Gender:M
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4854 ROCKING PORCH LN
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29485-6603
Mailing Address - Country:US
Mailing Address - Phone:803-899-2578
Mailing Address - Fax:
Practice Address - Street 1:246 ROCKMONT DR
Practice Address - Street 2:
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29708-6477
Practice Address - Country:US
Practice Address - Phone:803-619-9055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-31
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8947101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional