Provider Demographics
NPI:1134706310
Name:HUGHES, KRISTEN A (LCDCLLL)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:A
Last Name:HUGHES
Suffix:
Gender:
Credentials:LCDCLLL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8978 UNITED LN STE 102
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:OH
Mailing Address - Zip Code:45701-3668
Mailing Address - Country:US
Mailing Address - Phone:740-274-4246
Mailing Address - Fax:740-249-4944
Practice Address - Street 1:8978 UNITED LN STE 102
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-3668
Practice Address - Country:US
Practice Address - Phone:740-274-4246
Practice Address - Fax:740-274-4246
Is Sole Proprietor?:No
Enumeration Date:2021-03-25
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
OHLCDCIII.162820101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst