Healthcare Provider Details

I. General information

NPI: 1457262677
Provider Name (Legal Business Name): CHANEL HUGHES
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 W 4TH ST
WILLIAMSPORT PA
17701-6001
US

IV. Provider business mailing address

435 W 4TH ST
WILLIAMSPORT PA
17701-6001
US

V. Phone/Fax

Practice location:
  • Phone: 570-326-7895
  • Fax:
Mailing address:
  • Phone: 570-326-7895
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: