Provider Demographics
NPI:1013381987
Name:DEBRA HUGHES
Entity type:Organization
Organization Name:DEBRA HUGHES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:CLSW
Authorized Official - Phone:605-347-1369
Mailing Address - Street 1:1501 CENTRE ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57703-3002
Mailing Address - Country:US
Mailing Address - Phone:605-347-1369
Mailing Address - Fax:
Practice Address - Street 1:1501 CENTRE ST
Practice Address - Street 2:SUITE 101
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57703-3002
Practice Address - Country:US
Practice Address - Phone:605-347-1369
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-16
Last Update Date:2015-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD3174251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD446017085OtherBLUE CROSS
SD446017085OtherTRICARE
SD1124363601Medicaid