Provider Demographics
NPI:1306584867
Name:HULL, BETHANY (LMSW)
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:
Last Name:HULL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 E 12TH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-4252
Mailing Address - Country:US
Mailing Address - Phone:937-554-6431
Mailing Address - Fax:
Practice Address - Street 1:28 WHITE BRIDGE PIKE STE 300
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-1492
Practice Address - Country:US
Practice Address - Phone:615-356-4111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-24
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12773104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker