Provider Demographics
NPI:1427387968
Name:HUGHES, CHARLES ALLEN (MA, LCPC)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:ALLEN
Last Name:HUGHES
Suffix:
Gender:M
Credentials:MA, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 LAKE ST
Mailing Address - Street 2:STE. 433
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60301-1148
Mailing Address - Country:US
Mailing Address - Phone:708-445-1898
Mailing Address - Fax:708-445-1898
Practice Address - Street 1:1011 LAKE ST
Practice Address - Street 2:STE 433
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60301-1148
Practice Address - Country:US
Practice Address - Phone:708-445-1989
Practice Address - Fax:708-445-1898
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-11
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180007198101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health