Provider Demographics
NPI:1649591611
Name:JEFFREY D HUGHES, PSYD LLC
Entity type:Organization
Organization Name:JEFFREY D HUGHES, PSYD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:D
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:401-243-7210
Mailing Address - Street 1:340 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02909-1102
Mailing Address - Country:US
Mailing Address - Phone:401-243-7210
Mailing Address - Fax:401-490-2619
Practice Address - Street 1:340 BROADWAY
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02909-1102
Practice Address - Country:US
Practice Address - Phone:401-243-7210
Practice Address - Fax:401-490-2619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-14
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPS00979103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI689005240Medicare UPIN