MEDICARE: DANIELLE LULEK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator
2	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1093492738
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLE LULEK

Provider Business Mailing Address
First Line	:	PO BOX 68
Second Line	:
City	:	GOSHEN
State	:	MA
Zip	:	01032-0068
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	599 EAST ST
Second Line	:
City	:	WILLIAMSBURG
State	:	MA
Zip	:	01096-9772
Country	:	US
Telephone Number	:	413-388-0194
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/04/2023
Last Update Date	:	07/04/2023

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Directions to “ DANIELLE LULEK ” Practice Location

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