Healthcare Provider Details

I. General information

NPI: 1871839431
Provider Name (Legal Business Name): HEATHER PIEDRA HUGHES LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2012
Last Update Date: 08/18/2021
Certification Date: 08/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 SHIPYARD BLVD STE 100
WILMINGTON NC
28403-6194
US

IV. Provider business mailing address

5010 RANDALL PKWY
WILMINGTON NC
28403-2829
US

V. Phone/Fax

Practice location:
  • Phone: 107-925-5709
  • Fax:
Mailing address:
  • Phone: 910-791-5719
  • Fax: 910-799-8180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC007150
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: