=====================================================
General NPI Number Information
=====================================================
NPI Number | 1902772379
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ARTHUR CHARLES HUBBARD LPC
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/14/2025
-----------------------------------------------------
Last Update Date | 12/04/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 745 S MILLEDGE AVE STE 1A
-----------------------------------------------------
City | ATHENS
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30605-1292
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 706-498-9560
-----------------------------------------------------
Fax | 706-498-9568
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 320 WILLOW RUN
-----------------------------------------------------
City | ATHENS
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30606-2648
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | LPC015982
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------