| Hullistic Therapy, Llc | |
|
28 Lee Rd Lisbon CT 06351-3015 | |
| (860) 367-5343 | |
| (888) 492-8998 |
| Full Name | Hullistic Therapy, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 28 Lee Rd, Lisbon, Connecticut |
| Authorized Official Name and Position | Kathleen Hull (PROVIDER) |
| Authorized Official Contact | 8603675343 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hullistic Therapy, Llc 28 Lee Rd Lisbon CT 06351-3015 Ph: (860) 367-5343 | Hullistic Therapy, Llc 28 Lee Rd Lisbon CT 06351-3015 Ph: (860) 367-5343 |
| NPI Number | 1255914818 |
|---|---|
| Provider Enumeration Date | 05/03/2021 |
| Last Update Date | 05/03/2021 |
| Certification Date | 05/03/2021 |
| Medicare PECOS PAC ID | 4587064993 |
|---|---|
| Medicare Enrollment ID | O20210607001315 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255914818 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Kathleen Susan Hull |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558840603 PECOS PAC ID: 7911258330 Enrollment ID: I20180925001668 |
Kayla Nickerson, Lmft Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 140 Ross Hill Rd, Lisbon, CT 06351 Phone: 860-373-8802 |