Provider Demographics
NPI:1184946410
Name:HULGAN, AMBER (LMFT)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:HULGAN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:
Other - Last Name:HULGAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:PO BOX 60189
Mailing Address - Street 2:4359
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73146
Mailing Address - Country:US
Mailing Address - Phone:405-881-8346
Mailing Address - Fax:
Practice Address - Street 1:5517 S LINN AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73119-5834
Practice Address - Country:US
Practice Address - Phone:405-881-8346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-01
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1265101YM0800X
174400000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200437510AMedicaid