Provider Demographics
NPI:1306956388
Name:HUGHES, JANET O (MS)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:O
Last Name:HUGHES
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 425
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30086-0425
Mailing Address - Country:US
Mailing Address - Phone:770-240-8372
Mailing Address - Fax:770-442-7774
Practice Address - Street 1:11815 NORTHFALL LN STE 1006
Practice Address - Street 2:SUITE 1006
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009-7973
Practice Address - Country:US
Practice Address - Phone:770-240-8372
Practice Address - Fax:770-442-7774
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC002217101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA881671577AMedicaid