Provider Demographics
NPI:1518661693
Name:HULSE, DANIELLE MALENA (LPC)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:MALENA
Last Name:HULSE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 WESTIE WAY APT 304
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22406-5518
Mailing Address - Country:US
Mailing Address - Phone:757-777-5955
Mailing Address - Fax:
Practice Address - Street 1:410 PINE ST SE STE 150
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180-4877
Practice Address - Country:US
Practice Address - Phone:757-777-5955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-30
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701012312101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional