Provider Demographics
NPI:1558097121
Name:HUGHES, JAMAIKA JADE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:JAMAIKA
Middle Name:JADE
Last Name:HUGHES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2616 TAR HEEL DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76123-1648
Mailing Address - Country:US
Mailing Address - Phone:817-941-1255
Mailing Address - Fax:
Practice Address - Street 1:2616 TAR HEEL DR
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76123-1648
Practice Address - Country:US
Practice Address - Phone:682-990-8507
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-26
Last Update Date:2024-07-25
Deactivation Date:2022-07-26
Deactivation Code:
Reactivation Date:2022-08-24
Provider Licenses
StateLicense IDTaxonomies
TX66992104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX992507475OtherGEARUP FOR MENTAL HEALTH PLLC