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General NPI Number Information
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NPI Number | 1457716078
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Entity Type | Individual
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Provider Name | JUSTIN GRANT HUGHES CWS, LSUDC
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Gender | Male
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Dates
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Enumeration Date | 12/25/2015
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Last Update Date | 05/11/2023
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Provider Practice Location Address
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Address Line | 8072 S HIGHLAND DR
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City | COTTONWOOD HEIGHTS
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State | UT
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Zip | 84121-5037
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Country | US
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Telephone | 801-455-2687
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Fax |
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Provider Business Mailing Address
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Address Line | 1703 MEADOWLARK RD
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City | OREM
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State | UT
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Zip | 84097-2368
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Country | US
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Telephone | 435-841-2735
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 10946701-6006
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 10946701-3502
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License Number State | UT
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