Provider Demographics
NPI:1215161310
Name:HUBBARD, WILLIAM (MA)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:HUBBARD
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 N JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:STARKVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39759-2504
Mailing Address - Country:US
Mailing Address - Phone:662-323-9261
Mailing Address - Fax:662-324-9647
Practice Address - Street 1:302 N JACKSON ST
Practice Address - Street 2:
Practice Address - City:STARKVILLE
Practice Address - State:MS
Practice Address - Zip Code:39759-2504
Practice Address - Country:US
Practice Address - Phone:662-323-9261
Practice Address - Fax:662-324-9647
Is Sole Proprietor?:No
Enumeration Date:2009-05-05
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1632101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional