Healthcare Provider Details

I. General information

NPI: 1396295192
Provider Name (Legal Business Name): EVAN HUGHES TMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2016
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6000 UPTOWN BLVD NE STE 305
ALBUQUERQUE NM
87110-4148
US

IV. Provider business mailing address

6000 UPTOWN BLVD NE STE 305
ALBUQUERQUE NM
87110-4148
US

V. Phone/Fax

Practice location:
  • Phone: 505-219-1125
  • Fax: 505-393-4557
Mailing address:
  • Phone: 505-219-1125
  • Fax: 505-393-4557

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCMH0187301
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: