Kathy J Hughes | |
3923 N 29th St Sheboygan WI 53083-2004 | |
(920) 453-0082 | |
Not Available |
Full Name | Kathy J Hughes |
---|---|
Speciality | Community/Behavioral Health |
Location | 3923 N 29th St, Sheboygan, Wisconsin |
Authorized Official Name and Position | Kathy J Hughes (PROVIDER/BUSINESS OWNER) |
Authorized Official Contact | 9204530082 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Kathy J Hughes Po Box 873 Sheboygan WI 53082-0873 Ph: (920) 453-0082 | Kathy J Hughes 3923 N 29th St Sheboygan WI 53083-2004 Ph: (920) 453-0082 |
NPI Number | 1770053696 |
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Provider Enumeration Date | 12/04/2018 |
Last Update Date | 03/20/2024 |
Certification Date | 03/20/2024 |
Medicare PECOS PAC ID | 4587909122 |
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Medicare Enrollment ID | O20181231000107 |
Identifier | Type | State | Issuer |
---|---|---|---|
1770053696 | NPI | - | NPPES |
1366889388 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
Provider Name | Kathy J Hughes |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1366889388 PECOS PAC ID: 8628205770 Enrollment ID: I20131216001512 |
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