Healthcare Provider Details

I. General information

NPI: 1164830493
Provider Name (Legal Business Name): BARRY DANIEL HUGHES LPC UNDER SUPERVISIO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2014
Last Update Date: 10/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 HOPPE BLVD. SUITE 5
ADA OK
74820
US

IV. Provider business mailing address

210 E. MAIN ST. RESOURCE MANAGEMENT
ADA OK
74820
US

V. Phone/Fax

Practice location:
  • Phone: 580-436-1222
  • Fax: 580-436-1333
Mailing address:
  • Phone: 580-436-7211
  • Fax: 580-272-5757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: