1992903991 NPI number — MS. AKI K HUGHES-POLK MS, MA, LPCC,

Table of content: MS. AKI K HUGHES-POLK MS, MA, LPCC, (NPI 1992903991)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992903991 NPI number — MS. AKI K HUGHES-POLK MS, MA, LPCC,

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HUGHES-POLK
Provider First Name:
AKI
Provider Middle Name:
K
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MS, MA, LPCC,
Provider Gender Code:
U

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HUGHES-POLK
Provider Other First Name:
AKI
Provider Other Middle Name:
K
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MS, MA, LPCC,
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1992903991
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/31/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 490272
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BLAINE
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55434
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
612-913-8411
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
PO BOX 490272
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BLAINE
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55449-0272
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
612-913-8411
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/11/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  CC00024 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101Y00000X , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1790017721 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".




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