Provider Demographics
NPI:1063170710
Name:HUGHES, SUZANNE DIANA (LPC)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:DIANA
Last Name:HUGHES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:143 APPLE VALLEY WAY
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:MT
Mailing Address - Zip Code:59833-6912
Mailing Address - Country:US
Mailing Address - Phone:406-565-1829
Mailing Address - Fax:
Practice Address - Street 1:143 APPLE VALLEY WAY
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:MT
Practice Address - Zip Code:59833-6912
Practice Address - Country:US
Practice Address - Phone:406-565-1829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-30
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
ID1056101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID1056OtherLPC