Provider Demographics
NPI:1780887844
Name:HULL, SHELLEY REBECCA (LPC)
Entity type:Individual
Prefix:MRS
First Name:SHELLEY
Middle Name:REBECCA
Last Name:HULL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82 HUIE ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28027-5325
Mailing Address - Country:US
Mailing Address - Phone:704-721-5423
Mailing Address - Fax:
Practice Address - Street 1:87 PALASIDE DR NE
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-3056
Practice Address - Country:US
Practice Address - Phone:704-782-0115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3323101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool