Hubbard, Blaine Evan

Hubbard, Blaine Evan is an individual health care provider with primary practice located at 827 W Harvard St , Siloam Springs AR 72761-4013. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Hubbard, Blaine Evan can be contacted via phone (479) 549-3121.

Contact Information

Primary practice address
827 W Harvard St Siloam Springs AR 72761-4013
Phone: (479) 549-3121
Fax: (479) 750-4843
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X P0412055 Arkansas
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X M0502004 Arkansas

Profile Details

NPI number 1578592812
LBN Legal business name Hubbard, Blaine Evan
Credentials LPC, LMFT
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 30th, 2006
Last updated Jul 13th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578592812 NPPES
Arkansas Other 5Y327 BLUE SHIELD PROVIDER #

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