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General NPI Number Information
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NPI Number | 1184405227
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Entity Type | Individual
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Provider Name | SEAN TIMOTHY HULING CSWA
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Gender | Male
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Dates
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Enumeration Date | 10/12/2023
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Last Update Date | 05/23/2024
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Provider Practice Location Address
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Address Line | 150 S WALL ST
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City | COOS BAY
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State | OR
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Zip | 97420-3233
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Country | US
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Telephone | 541-435-7200
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Fax |
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Provider Business Mailing Address
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Address Line | 6040 MARSHALL MILL RD
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City | LIZELLA
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State | GA
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Zip | 31052-7806
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Country | US
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Telephone | 478-250-2586
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | MSW011446
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | A15262
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License Number State | OR
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