Healthcare Provider Details

I. General information

NPI: 1336856756
Provider Name (Legal Business Name): MELISSA HULTS LCSW, LCADC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MELISSA BACULIS LCSW, LCADC

II. Dates (important events)

Enumeration Date: 11/04/2022
Last Update Date: 07/16/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 BAYARD ST
NEW BRUNSWICK NJ
08901-2389
US

IV. Provider business mailing address

9 STRAWBERRY LN
HILLSBOROUGH NJ
08844-5411
US

V. Phone/Fax

Practice location:
  • Phone: 908-566-8745
  • Fax:
Mailing address:
  • Phone: 908-566-8745
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number44SL06675800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: