Provider Demographics
NPI:1154855708
Name:HULL, EBONY J (LISW-S)
Entity Type:Individual
Prefix:
First Name:EBONY
Middle Name:J
Last Name:HULL
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27801 EUCLID AVE STE 316
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44132-3547
Mailing Address - Country:US
Mailing Address - Phone:216-562-9960
Mailing Address - Fax:
Practice Address - Street 1:27801 EUCLID AVE STE 316
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44132-3547
Practice Address - Country:US
Practice Address - Phone:216-562-9960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-19
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHL.901766-S1041C0700X
OH16000961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty