Provider Demographics
NPI:1366410615
Name:DALE HUGHES LICENSED CLINICAL SOCIAL WORKER CORP
Entity type:Organization
Organization Name:DALE HUGHES LICENSED CLINICAL SOCIAL WORKER CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DALE
Authorized Official - Middle Name:
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:310-373-3888
Mailing Address - Street 1:25500 HAWTHORNE BLVD STE 1152
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-6834
Mailing Address - Country:US
Mailing Address - Phone:310-373-3888
Mailing Address - Fax:310-373-5354
Practice Address - Street 1:25500 HAWTHORNE BLVD STE 1152
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-6834
Practice Address - Country:US
Practice Address - Phone:310-373-3888
Practice Address - Fax:310-373-5354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-11
Last Update Date:2020-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS78641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty