Provider Demographics
NPI:1790142925
Name:HUGHES, CHANEY (BCABA)
Entity Type:Individual
Prefix:
First Name:CHANEY
Middle Name:
Last Name:HUGHES
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3155 N COLLEGE AVE STE 108
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-3500
Mailing Address - Country:US
Mailing Address - Phone:479-957-9121
Mailing Address - Fax:479-777-9967
Practice Address - Street 1:3155 N COLLEGE AVE STE 108
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-3500
Practice Address - Country:US
Practice Address - Phone:479-957-9121
Practice Address - Fax:479-777-9967
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-19
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARRBT-17-31122106S00000X
171M00000X
AR0-21-11869106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No171M00000XOther Service ProvidersCase Manager/Care Coordinator