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NPI Code Detail

MEDICARE: TEGAN HULSE LMSW

MEDICARE: TEGAN HULSE LMSW
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
11041C0700XClinical Social Worker090378-1NY

General Provider Information

NPI Number : 1215381447
Entity Type Code : Individual
Provider Name (Legal Business Name) : TEGAN HULSE LMSW
Provider Business Mailing Address
First Line : 521 MORICHES MIDDLE ISLAND RD
Second Line :
City : MANORVILLE
State : NY
Zip : 11949-2120
Country : US
Telephone Number : 631-830-7948
Fax Number :
Provider Business Practice Location Address
First Line : 208 ROANOKE AVE
Second Line :
City : RIVERHEAD
State : NY
Zip : 11901-2706
Country : US
Telephone Number : 631-591-7583
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2016
Last Update Date : 04/15/2026

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