Provider Demographics
NPI:1942383377
Name:HUGHES, PAMELA M (PHD, LCSW)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:M
Last Name:HUGHES
Suffix:
Gender:F
Credentials:PHD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 QUAKER RD UNIT 279
Mailing Address - Street 2:
Mailing Address - City:EAST AURORA
Mailing Address - State:NY
Mailing Address - Zip Code:14052-8011
Mailing Address - Country:US
Mailing Address - Phone:716-260-1538
Mailing Address - Fax:
Practice Address - Street 1:350 GREENHAVEN TER
Practice Address - Street 2:
Practice Address - City:TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14150-5547
Practice Address - Country:US
Practice Address - Phone:716-260-1538
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-21
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0542421104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
000269010901OtherUNIVERA
000590349001OtherBLUE CROSS
6212744OtherINDEPENDENT HEALTH
000269010901OtherUNIVERA