Provider Demographics
NPI:1699891762
Name:HULBERT, SUSAN W (LCSW)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:W
Last Name:HULBERT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 MARI LANE
Mailing Address - Street 2:
Mailing Address - City:FREWSBURG
Mailing Address - State:NY
Mailing Address - Zip Code:14738
Mailing Address - Country:US
Mailing Address - Phone:716-569-2077
Mailing Address - Fax:716-664-5186
Practice Address - Street 1:517 SPRING ST
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:NY
Practice Address - Zip Code:14701-5323
Practice Address - Country:US
Practice Address - Phone:716-484-9840
Practice Address - Fax:716-664-5186
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2009-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0375051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical