Provider Demographics
NPI:1912042185
Name:HUGHES, JEANMARIE (LSCSW)
Entity Type:Individual
Prefix:MRS
First Name:JEANMARIE
Middle Name:
Last Name:HUGHES
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:MISS
Other - First Name:JEANMARIE
Other - Middle Name:
Other - Last Name:MAXWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:4455 ALLEN LN
Mailing Address - Street 2:SUITE 130
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89031-2204
Mailing Address - Country:US
Mailing Address - Phone:702-385-1072
Mailing Address - Fax:
Practice Address - Street 1:4455 ALLEN LN
Practice Address - Street 2:SUITE 130
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89031-2204
Practice Address - Country:US
Practice Address - Phone:702-385-1072
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2011-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5631-C104100000X
CA104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker