Provider Demographics
NPI:1790844694
Name:HULLFISH, CORLYNN ANN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CORLYNN
Middle Name:ANN
Last Name:HULLFISH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:53 S MAIN ST
Mailing Address - Street 2:SUITE 3F
Mailing Address - City:MEDFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08055-2442
Mailing Address - Country:US
Mailing Address - Phone:609-410-8607
Mailing Address - Fax:609-257-0680
Practice Address - Street 1:53 S MAIN ST
Practice Address - Street 2:SUITE 3F
Practice Address - City:MEDFORD
Practice Address - State:NJ
Practice Address - Zip Code:08055-2442
Practice Address - Country:US
Practice Address - Phone:609-410-8607
Practice Address - Fax:609-257-0680
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC052496001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical