Provider Demographics
NPI:1659732493
Name:HUGHES, MICHELLE CALLAHAN (MA, LPA, HSP-A)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:CALLAHAN
Last Name:HUGHES
Suffix:
Gender:F
Credentials:MA, LPA, HSP-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 475
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NC
Mailing Address - Zip Code:27536-0475
Mailing Address - Country:US
Mailing Address - Phone:252-425-7201
Mailing Address - Fax:
Practice Address - Street 1:9033 LAKE ROYALE
Practice Address - Street 2:
Practice Address - City:LOUISBURG
Practice Address - State:NC
Practice Address - Zip Code:27549-7208
Practice Address - Country:US
Practice Address - Phone:252-477-0008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-07
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4448103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical