1346411725 NPI number — MS. JYNGER MORRIS HULING LPC

Table of content: MS. JYNGER MORRIS HULING LPC (NPI 1346411725)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346411725 NPI number — MS. JYNGER MORRIS HULING LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HULING
Provider First Name:
JYNGER
Provider Middle Name:
MORRIS
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MORRIS
Provider Other First Name:
JYNGER
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LPC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1346411725
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/15/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2109 N PATTERSON ST
Provider Second Line Business Mailing Address:
SUITE B
Provider Business Mailing Address City Name:
VALDOSTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
31602-2990
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
229-232-4833
Provider Business Mailing Address Fax Number:
229-245-9805

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2109 N PATTERSON ST
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
VALDOSTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
31602-2990
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
229-232-4833
Provider Business Practice Location Address Fax Number:
229-245-9805
Provider Enumeration Date:
03/13/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  LPC005191 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 435682271C , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".




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