Provider Demographics
NPI:1548391071
Name:HULL, JAMES S (LICDC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:S
Last Name:HULL
Suffix:
Gender:M
Credentials:LICDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 E COURT ST
Mailing Address - Street 2:
Mailing Address - City:SIDNEY
Mailing Address - State:OH
Mailing Address - Zip Code:45365-2810
Mailing Address - Country:US
Mailing Address - Phone:937-492-6970
Mailing Address - Fax:937-492-6971
Practice Address - Street 1:500 E COURT ST
Practice Address - Street 2:
Practice Address - City:SIDNEY
Practice Address - State:OH
Practice Address - Zip Code:45365-2810
Practice Address - Country:US
Practice Address - Phone:937-492-6970
Practice Address - Fax:937-492-6971
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH872334101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)