MEDICARE: VICTORIA GULINO LMHC

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	101YM0800X	Mental Health Counselor	006373-1	NY
2	101Y00000X	Counselor	26340	NY

General Provider Information

NPI Number	:	1114377884
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTORIA GULINO LMHC

Provider Business Mailing Address
First Line	:	37 YOUNGS HILL RD
Second Line	:
City	:	HUNTINGTON
State	:	NY
Zip	:	11743-2154
Country	:	US
Telephone Number	:	631-456-2560
Fax Number	:

Provider Business Practice Location Address
First Line	:	301 E MAIN ST
Second Line	:
City	:	CENTERPORT
State	:	NY
Zip	:	11721-1439
Country	:	US
Telephone Number	:	631-456-2560
Fax Number	:

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

Provider Enumeration Date	:	06/14/2016
Last Update Date	:	06/14/2016

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