Provider Demographics
NPI:1114605169
Name:KULL INDIVIDUALIZED PSYCHOTHERAPY PRACTICE COUNSELING LCSW PC
Entity Type:Organization
Organization Name:KULL INDIVIDUALIZED PSYCHOTHERAPY PRACTICE COUNSELING LCSW PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KULL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-575-4769
Mailing Address - Street 1:330 W 58TH ST STE 401
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-1821
Mailing Address - Country:US
Mailing Address - Phone:212-575-4769
Mailing Address - Fax:
Practice Address - Street 1:330 W 58TH ST STE 401
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1821
Practice Address - Country:US
Practice Address - Phone:212-575-4769
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-10
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty