Provider Demographics
NPI:1285989319
Name:HUGHES, JENNIFER (LC S W)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:HUGHES
Suffix:
Gender:F
Credentials:LC S W
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 59TH AVE S
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33712-5218
Mailing Address - Country:US
Mailing Address - Phone:727-866-2809
Mailing Address - Fax:
Practice Address - Street 1:9887 4TH ST N
Practice Address - Street 2:SUITE 231
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33702-2477
Practice Address - Country:US
Practice Address - Phone:727-578-0011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-15
Last Update Date:2012-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW108271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical