Provider Demographics
NPI:1376643551
Name:HULL, VICKIE S (LCMFT)
Entity type:Individual
Prefix:
First Name:VICKIE
Middle Name:S
Last Name:HULL
Suffix:
Gender:F
Credentials:LCMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1018 WILDWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66049-3752
Mailing Address - Country:US
Mailing Address - Phone:785-865-4045
Mailing Address - Fax:785-865-4045
Practice Address - Street 1:1201 WAKARUSA DR
Practice Address - Street 2:SUITE E2, #103
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66049-4722
Practice Address - Country:US
Practice Address - Phone:785-856-1395
Practice Address - Fax:785-865-4045
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2009-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS686106H00000X
KS716106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist