Provider Demographics
NPI:1982945432
Name:HUGHES, SHAUNA RAE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:SHAUNA
Middle Name:RAE
Last Name:HUGHES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MISS
Other - First Name:SHAUNA
Other - Middle Name:RAE
Other - Last Name:HAZEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:650 S PEORIA AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74120-4429
Mailing Address - Country:US
Mailing Address - Phone:918-991-6641
Mailing Address - Fax:918-560-1399
Practice Address - Street 1:1 W 36TH ST N
Practice Address - Street 2:SUITE 1
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74106-1700
Practice Address - Country:US
Practice Address - Phone:918-425-4200
Practice Address - Fax:918-560-1399
Is Sole Proprietor?:No
Enumeration Date:2013-03-08
Last Update Date:2018-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6996101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor