Healthcare Provider Details

I. General information

NPI: 1295433373
Provider Name (Legal Business Name): STEPHEN HULETT LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/20/2023
Last Update Date: 10/17/2026
Certification Date: 10/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

427A LAKE BARNEGAT DR N
FORKED RIVER NJ
08731-1622
US

IV. Provider business mailing address

427A LAKE BARNEGAT DR N
FORKED RIVER NJ
08731-1622
US

V. Phone/Fax

Practice location:
  • Phone: 516-857-4857
  • Fax:
Mailing address:
  • Phone: 516-857-4857
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC06720200
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number104410
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: