Provider Demographics
NPI:1629148218
Name:BULL, HANNAH-LEIGH (LMFT)
Entity Type:Individual
Prefix:MS
First Name:HANNAH-LEIGH
Middle Name:
Last Name:BULL
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1035 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:FORT BRAGG
Mailing Address - State:CA
Mailing Address - Zip Code:95437-3840
Mailing Address - Country:US
Mailing Address - Phone:505-901-1476
Mailing Address - Fax:
Practice Address - Street 1:1035 CEDAR ST
Practice Address - Street 2:
Practice Address - City:FORT BRAGG
Practice Address - State:CA
Practice Address - Zip Code:95437-3840
Practice Address - Country:US
Practice Address - Phone:505-901-1476
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM4537106H00000X
CA34963106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM00NM00JC05OtherBCBS
NMNM101479OtherVALUE OPTIONS
NM201036193OtherPRESBYTERIAN
NM38905035Medicaid