Provider Demographics
NPI:1346881638
Name:HULL BEHAVIORAL HEALTH LLC
Entity Type:Organization
Organization Name:HULL BEHAVIORAL HEALTH LLC
Other - Org Name:HULL BEHAVIORAL HEALTH
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER / PSYCHOTHERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:BARON
Authorized Official - Last Name:HULL
Authorized Official - Suffix:
Authorized Official - Credentials:LLP
Authorized Official - Phone:313-215-0385
Mailing Address - Street 1:1012 SOMERSET AVE
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48230-1334
Mailing Address - Country:US
Mailing Address - Phone:313-215-0385
Mailing Address - Fax:
Practice Address - Street 1:16824 KERCHEVAL AVE STE 215
Practice Address - Street 2:
Practice Address - City:GROSSE POINTE PARK
Practice Address - State:MI
Practice Address - Zip Code:48230-1563
Practice Address - Country:US
Practice Address - Phone:313-215-0385
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-08
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty