Provider Demographics
NPI:1417409848
Name:HULL, ASHLEY LYNETTE (LCDCII)
Entity Type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:LYNETTE
Last Name:HULL
Suffix:
Gender:F
Credentials:LCDCII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1991 BRYDEN RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43205-1601
Mailing Address - Country:US
Mailing Address - Phone:614-252-0660
Mailing Address - Fax:
Practice Address - Street 1:1991 BRYDEN RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43205-1601
Practice Address - Country:US
Practice Address - Phone:614-252-0660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-02
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1411117101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)