Healthcare Provider Details

I. General information

NPI: 1306241708
Provider Name (Legal Business Name): KRISTEN HULLINGER MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/28/2014
Last Update Date: 10/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 WILLOW AVE
HOBOKEN NJ
07030-3807
US

IV. Provider business mailing address

317 WILLOW AVE
HOBOKEN NJ
07030-3807
US

V. Phone/Fax

Practice location:
  • Phone: 201-499-0836
  • Fax:
Mailing address:
  • Phone: 201-499-0836
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC04327600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: