Provider Demographics
NPI:1780139303
Name:HUGHES, JOEL (PHD)
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:
Last Name:HUGHES
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4850 JUNE AVE
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-1595
Mailing Address - Country:US
Mailing Address - Phone:330-622-3387
Mailing Address - Fax:
Practice Address - Street 1:4850 JUNE AVE
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-1595
Practice Address - Country:US
Practice Address - Phone:330-622-3387
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-24
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6015103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical