Healthcare Provider Details

I. General information

NPI: 1235396102
Provider Name (Legal Business Name): JUDY PAYNE HUGHES L.P.C. ; RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2008
Last Update Date: 10/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2542 ROUTE 66 #303
CHATHAM NY
12037-1815
US

IV. Provider business mailing address

2542 ROUTE 66 #303
CHATHAM NY
12037-1815
US

V. Phone/Fax

Practice location:
  • Phone: 703-505-3721
  • Fax:
Mailing address:
  • Phone: 703-505-3721
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701001714
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code163WA0400X
TaxonomyAddiction (Substance Use Disorder) Registered Nurse
License Number662477
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: