Healthcare Provider Details

I. General information

NPI: 1043132392
Provider Name (Legal Business Name): ANTHONY WILDER HUGHES LCSW-A
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1251 GOODE ST
RALEIGH NC
27603-2261
US

IV. Provider business mailing address

2611 SHENANDOAH AVE
DURHAM NC
27704-4215
US

V. Phone/Fax

Practice location:
  • Phone: 919-886-3287
  • Fax:
Mailing address:
  • Phone: 919-886-3287
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP024162
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: