Provider Demographics
NPI:1740152131
Name:HULL, GAGE
Entity type:Individual
Prefix:
First Name:GAGE
Middle Name:
Last Name:HULL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 GARDEN ST
Mailing Address - Street 2:
Mailing Address - City:EAST TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02718-1022
Mailing Address - Country:US
Mailing Address - Phone:774-504-4622
Mailing Address - Fax:
Practice Address - Street 1:16 GARDEN ST
Practice Address - Street 2:
Practice Address - City:EAST TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02718-1022
Practice Address - Country:US
Practice Address - Phone:774-504-4622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-23
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health