Provider Demographics
NPI:1073795159
Name:HULL, SARAH A (MED, LMHC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:A
Last Name:HULL
Suffix:
Gender:F
Credentials:MED, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 N 37TH AVE
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-2708
Mailing Address - Country:US
Mailing Address - Phone:509-208-5672
Mailing Address - Fax:
Practice Address - Street 1:107 W ORCHARD AVE
Practice Address - Street 2:
Practice Address - City:SELAH
Practice Address - State:WA
Practice Address - Zip Code:98942-1329
Practice Address - Country:US
Practice Address - Phone:509-208-5672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-30
Last Update Date:2024-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACG60149868171M00000X
WALH60680303101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No171M00000XOther Service ProvidersCase Manager/Care Coordinator