MEDICARE: DESTINY HULSEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	21904	OK

General Provider Information

NPI Number	:	1265937031
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DESTINY HULSEY

Provider Business Mailing Address
First Line	:	3904 HARTLINE DR
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73115-4306
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3904 HARTLINE DR
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73115-4306
Country	:	US
Telephone Number	:	405-370-4670
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/26/2018
Last Update Date	:	12/29/2025

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Directions to “ DESTINY HULSEY ” Practice Location

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