Provider Demographics
NPI:1629459870
Name:HULLUM, BILLIE (CADCII, BCBC, BCACLC)
Entity Type:Individual
Prefix:
First Name:BILLIE
Middle Name:
Last Name:HULLUM
Suffix:
Gender:F
Credentials:CADCII, BCBC, BCACLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 HUDSON TRCE
Mailing Address - Street 2:SUITE 111
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30907-2010
Mailing Address - Country:US
Mailing Address - Phone:706-799-7743
Mailing Address - Fax:706-262-2899
Practice Address - Street 1:207 HUDSON TRCE
Practice Address - Street 2:SUITE 111
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30907-2010
Practice Address - Country:US
Practice Address - Phone:706-799-7743
Practice Address - Fax:706-262-2899
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-13
Last Update Date:2015-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0612101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)