Basic Information
Provider Information
NPI: 1033340831
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HUGHES
FirstName: MICHELLE
MiddleName: MARGARET
NamePrefix:  
NameSuffix:  
Credential: LMSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 490 E RIDGE RD
Address2:  
City: ROCHESTER
State: NY
PostalCode: 146211229
CountryCode: US
TelephoneNumber: 5859222567
FaxNumber: 5859222646
Practice Location
Address1: 490 E RIDGE RD
Address2:  
City: ROCHESTER
State: NY
PostalCode: 146211229
CountryCode: US
TelephoneNumber: 5859222567
FaxNumber: 5859222646
Other Information
ProviderEnumerationDate: 07/29/2009
LastUpdateDate: 07/29/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
104100000X079455NYY Behavioral Health & Social Service ProvidersSocial Worker 

No ID Information.


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