Healthcare Provider Details

I. General information

NPI: 1609201094
Provider Name (Legal Business Name): ANNETTE DONOVAN-HUGHES LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2013
Last Update Date: 08/31/2022
Certification Date: 08/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 AUSTELL POWDER SPRINGS RD STE 207
AUSTELL GA
30106-2435
US

IV. Provider business mailing address

PO BOX 941
AUSTELL GA
30168-1053
US

V. Phone/Fax

Practice location:
  • Phone: 678-458-0458
  • Fax:
Mailing address:
  • Phone: 678-458-0458
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberMSW005832
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCSW008050
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCSW008050
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License NumberMSW005832
License Number StateGA
# 5
Primary TaxonomyN
Taxonomy Code102L00000X
TaxonomyPsychoanalyst
License NumberCSW008050
License Number StateGA
# 6
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberCSW008050
License Number StateGA
# 7
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License NumberMSW005832
License Number StateGA
# 8
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License NumberCSW008050
License Number StateGA
# 9
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 10
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberCSW008050
License Number StateGA
# 11
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 12
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License NumberCSW008050
License Number StateGA
# 13
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberCSW008050
License Number StateGA
# 14
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW008050
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: