Provider Demographics
NPI:1740362557
Name:MCHUGH, BRIAN (MS LMSW)
Entity type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:
Last Name:MCHUGH
Suffix:
Gender:M
Credentials:MS LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:376 W GILFORD RD
Mailing Address - Street 2:
Mailing Address - City:CARO
Mailing Address - State:MI
Mailing Address - Zip Code:48723-1102
Mailing Address - Country:US
Mailing Address - Phone:989-553-1316
Mailing Address - Fax:877-249-1958
Practice Address - Street 1:5271 KINGSTON RD
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:MI
Practice Address - Zip Code:48741-9769
Practice Address - Country:US
Practice Address - Phone:989-553-1316
Practice Address - Fax:877-249-1958
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2010-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010646771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical