Provider Demographics
NPI:1659456713
Name:TULLI, JENNIFER (LISW-S, LCDC III)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:TULLI
Suffix:
Gender:F
Credentials:LISW-S, LCDC III
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24024 E OAKLAND RD
Mailing Address - Street 2:
Mailing Address - City:BAY VILLAGE
Mailing Address - State:OH
Mailing Address - Zip Code:44140-2829
Mailing Address - Country:US
Mailing Address - Phone:440-617-6017
Mailing Address - Fax:
Practice Address - Street 1:2500 METROHEALTH DRIVE
Practice Address - Street 2:METROHEALTH MEDICAL CENTER
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44109-3322
Practice Address - Country:US
Practice Address - Phone:216-778-8305
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2016-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-00100631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical