Provider Demographics
NPI:1760947279
Name:HUGHES, CASSADY L (BCBA)
Entity Type:Individual
Prefix:
First Name:CASSADY
Middle Name:L
Last Name:HUGHES
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7108 S KANNER HWY
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34997-7462
Mailing Address - Country:US
Mailing Address - Phone:470-350-4138
Mailing Address - Fax:321-250-7463
Practice Address - Street 1:495 GRAND BLVD
Practice Address - Street 2:
Practice Address - City:MIRAMAR BEACH
Practice Address - State:FL
Practice Address - Zip Code:32550-1897
Practice Address - Country:US
Practice Address - Phone:470-350-4138
Practice Address - Fax:321-250-7463
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-08
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL21-55832103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst