Provider Demographics
NPI:1992068597
Name:HUBE, JEREMY EDWARD
Entity type:Individual
Prefix:MR
First Name:JEREMY
Middle Name:EDWARD
Last Name:HUBE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:635 FARRAGUT ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-4009
Mailing Address - Country:US
Mailing Address - Phone:202-459-8920
Mailing Address - Fax:
Practice Address - Street 1:4201 CONNECTICUT AVE NW STE 300
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-1162
Practice Address - Country:US
Practice Address - Phone:202-624-0010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-19
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor