Healthcare Provider Details

I. General information

NPI: 1417275884
Provider Name (Legal Business Name): CHRISTOPHER ELLIOTT HULL LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2010
Last Update Date: 06/06/2023
Certification Date: 06/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1672 SOUTH 48TH STREET SUITE B
SPRINGDALE AR
72762-5880
US

IV. Provider business mailing address

6410 TALL OAKS LOOP N
SPRINGDALE AR
72762
US

V. Phone/Fax

Practice location:
  • Phone: 479-202-6300
  • Fax: 479-202-6300
Mailing address:
  • Phone: 813-766-8431
  • Fax: 303-730-1531

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberP2007045
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0011639
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: