Provider Demographics
NPI:1235401886
Name:HUGHES, HILLARY E (LCSW)
Entity type:Individual
Prefix:
First Name:HILLARY
Middle Name:E
Last Name:HUGHES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:HILLARY
Other - Middle Name:
Other - Last Name:ROETHLISBERGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:861 SW MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97333-4512
Mailing Address - Country:US
Mailing Address - Phone:541-974-8873
Mailing Address - Fax:
Practice Address - Street 1:861 SW MADISON AVE
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97333-4512
Practice Address - Country:US
Practice Address - Phone:541-974-8873
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-28
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCSW-272471041C0700X
ORL77881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID1235401886Medicaid
ID1235401886Medicaid
ID20004455Medicare PIN
ID20004456Medicare PIN
ID20004459Medicare PIN
ID20004458Medicare PIN