Provider Demographics
NPI:1992965222
Name:HUGHES, TYCY
Entity type:Individual
Prefix:
First Name:TYCY
Middle Name:
Last Name:HUGHES
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 W 6TH AVE PMB 160
Mailing Address - Street 2:
Mailing Address - City:ELLENSBURG
Mailing Address - State:WA
Mailing Address - Zip Code:98926-3106
Mailing Address - Country:US
Mailing Address - Phone:657-999-2162
Mailing Address - Fax:888-538-7694
Practice Address - Street 1:110 W 6TH AVE PMB 160
Practice Address - Street 2:
Practice Address - City:ELLENSBURG
Practice Address - State:WA
Practice Address - Zip Code:98926-3106
Practice Address - Country:US
Practice Address - Phone:509-668-2121
Practice Address - Fax:888-538-7694
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-10
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA171M00000X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator