Provider Demographics
NPI:1750742763
Name:ULSH, FAITH (LPC, LMHC, ACS)
Entity type:Individual
Prefix:
First Name:FAITH
Middle Name:
Last Name:ULSH
Suffix:
Gender:F
Credentials:LPC, LMHC, ACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:680 ROUTE 211 E STE 3B
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10941-1757
Mailing Address - Country:US
Mailing Address - Phone:845-459-2670
Mailing Address - Fax:
Practice Address - Street 1:680 ROUTE 211 E STE 3B
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10941-1757
Practice Address - Country:US
Practice Address - Phone:845-459-2670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-18
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00683400101YM0800X
NY011291-01101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health