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NPI Code Detail

MEDICARE: JUSTIN GRANT HUGHES CWS, LSUDC

MEDICARE: JUSTIN GRANT HUGHES CWS, LSUDC
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
1101YA0400XAddiction (Substance Use Disorder) Counselor10946701-6006UT
21041C0700XClinical Social Worker10946701-3502UT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1457716078
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUSTIN GRANT HUGHES CWS, LSUDC
Provider Business Mailing Address
First Line : 1703 MEADOWLARK RD
Second Line :
City : OREM
State : UT
Zip : 84097-2368
Country : US
Telephone Number : 435-841-2735
Fax Number :
Provider Business Practice Location Address
First Line : 8072 S HIGHLAND DR
Second Line :
City : COTTONWOOD HEIGHTS
State : UT
Zip : 84121-5037
Country : US
Telephone Number : 801-455-2687
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/25/2015
Last Update Date : 05/11/2023

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