Provider Demographics
NPI:1184239386
Name:HULEY, PRISCILLA TANISHIA (LCPC)
Entity type:Individual
Prefix:MS
First Name:PRISCILLA
Middle Name:TANISHIA
Last Name:HULEY
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1409 N GLENWOOD AVE APT 0E
Mailing Address - Street 2:
Mailing Address - City:GRIFFITH
Mailing Address - State:IN
Mailing Address - Zip Code:46319-1964
Mailing Address - Country:US
Mailing Address - Phone:708-227-7098
Mailing Address - Fax:
Practice Address - Street 1:9445 INDIANAPOLIS BLVD # 1212
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:IN
Practice Address - Zip Code:46322-2648
Practice Address - Country:US
Practice Address - Phone:708-227-4080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-14
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39004253A101YM0800X
IL180014220101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN39004253AOtherMENTAL HEALTH COUNSELOR LICENSE