Provider Demographics
NPI:1730075755
Name:HULBERT, CRAIG (SUDC)
Entity type:Individual
Prefix:
First Name:CRAIG
Middle Name:
Last Name:HULBERT
Suffix:
Gender:M
Credentials:SUDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5635 S WATERBURY WAY STE C102
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84121-6217
Mailing Address - Country:US
Mailing Address - Phone:801-473-3963
Mailing Address - Fax:801-797-1220
Practice Address - Street 1:5635 S WATERBURY WAY STE C102
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84121-6217
Practice Address - Country:US
Practice Address - Phone:801-473-3963
Practice Address - Fax:801-797-1220
Is Sole Proprietor?:No
Enumeration Date:2025-06-16
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT14174896-6006101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)