Provider Demographics
NPI:1194964031
Name:HUGHES, JUSTIN K (LPC)
Entity type:Individual
Prefix:MR
First Name:JUSTIN
Middle Name:K
Last Name:HUGHES
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4099 MCEWEN RD
Mailing Address - Street 2:SUITE 600
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75244-5030
Mailing Address - Country:US
Mailing Address - Phone:972-387-3898
Mailing Address - Fax:972-387-3987
Practice Address - Street 1:4099 MCEWEN RD
Practice Address - Street 2:SUITE 600
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75244-5030
Practice Address - Country:US
Practice Address - Phone:972-387-3898
Practice Address - Fax:972-387-3987
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-17
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64574101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX45-2790840OtherEIN (TAX ID)