Healthcare Provider Details

I. General information

NPI: 1518404029
Provider Name (Legal Business Name): LANA JOAN HULL LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: L JOAN HULL LPC

II. Dates (important events)

Enumeration Date: 01/22/2017
Last Update Date: 11/28/2023
Certification Date: 11/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

781 AVIS DR SUITE 200
ANN ARBOR MI
48108-8959
US

IV. Provider business mailing address

2009 MEDFORD RD G254
ANN ARBOR MI
48104-4945
US

V. Phone/Fax

Practice location:
  • Phone: 734-477-0135
  • Fax: 734-477-0213
Mailing address:
  • Phone: 734-717-0431
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401002941
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6401002941
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: