Provider Demographics
NPI:1881689420
Name:HUBBARD, WILLIAM EDWARD JR (LICSW)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:EDWARD
Last Name:HUBBARD
Suffix:JR
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 PLAIN ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:MS
Mailing Address - Zip Code:39701-3444
Mailing Address - Country:US
Mailing Address - Phone:662-434-2239
Mailing Address - Fax:662-434-2110
Practice Address - Street 1:1307 E ELM ST
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:AL
Practice Address - Zip Code:35611-5318
Practice Address - Country:US
Practice Address - Phone:256-232-3661
Practice Address - Fax:256-355-6092
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL0836C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical