Kenneth Edward Hultman

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LC0147 Issued in MD

Practice address

966 Laa la Way
Diamondhead, MS 39525-4122

Phone

(228) 327-5375

NPI assigned

Mar 24, 2021

Last updated

Mar 24, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1616544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616544000000",
    "number": "1871170134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "966 LAA LA WAY",
            "city": "DIAMONDHEAD",
            "state": "MS",
            "postal_code": "395254122",
            "telephone_number": "228-327-5375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "966 LAA LA WAY",
            "city": "DIAMONDHEAD",
            "state": "MS",
            "postal_code": "395254122",
            "telephone_number": "228-327-5375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HULTMAN",
        "first_name": "KENNETH",
        "middle_name": "EDWARD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-24",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LC0147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Eugene Harris, PH.D.
• Preethi S Harrison, PA-C
• Allison Kae Hennessey
• Desmond Wayne Hoda, D.C.
• John Cameron Hodge, D.O.
• Ronald Fulton Kellum, M.D.
• Deedy Killen, R.N.
• Micah Anthony Ladner, FNP-C
• Brittany Michelle Lander, FNP-C
• Love's Pharmacy No 2, Inc

• Mental Health Counselor in Diamondhead, MS
• Providers in Diamondhead, MS by specialty
• Mental Health Counselor in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.