Healthcare Provider Details
I. General information
NPI: 1346447539
Provider Name (Legal Business Name): THOMAS CLAYTON HUGHES LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/29/2007
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
619 CANAL AVE E
WYNNE AR
72396-3003
US
IV. Provider business mailing address
619 CANAL AVE E
WYNNE AR
72396-3003
US
V. Phone/Fax
- Phone: 870-587-7020
- Fax: 870-587-7020
- Phone: 870-587-7020
- Fax: 870-587-7020
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | P1203034 |
| License Number State | AR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: