MEDICARE: DANIELLE HUGHES LCMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	9800	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	128-506-8642	OTHER		NPI

General Provider Information

NPI Number	:	1285078642
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLE HUGHES LCMHC

Provider Business Mailing Address
First Line	:	PO BOX 11511
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28220-1511
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4117 PARK ROAD, #11511
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28209-2214
Country	:	US
Telephone Number	:	704-312-0686
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/29/2013
Last Update Date	:	05/24/2021

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