MEDICARE: MICHAEL THULL MSW, LCSW

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	LCAS25821	NC
2	1041C0700X	Clinical Social Worker	C006152	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285885822
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL THULL MSW, LCSW

Provider Business Mailing Address
First Line	:	2638 WILLARD DAIRY RD STE 102
Second Line	:
City	:	HIGH POINT
State	:	NC
Zip	:	27265-8236
Country	:	US
Telephone Number	:	336-354-7980
Fax Number	:

Provider Business Practice Location Address
First Line	:	1814 EASTCHESTER DR
Second Line	:
City	:	HIGH POINT
State	:	NC
Zip	:	27265-1403
Country	:	US
Telephone Number	:	336-505-8122
Fax Number	:

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

Provider Enumeration Date	:	10/01/2008
Last Update Date	:	03/23/2026

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