MEDICARE: MRS. KRISTIN LINK ULLRICH M.ED

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	0704017523	VA

General Provider Information

NPI Number	:	1326859323
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KRISTIN LINK ULLRICH M.ED

Provider Business Mailing Address
First Line	:	910 DRUID AVE
Second Line	:
City	:	CHARLOTTESVILLE
State	:	VA
Zip	:	22902-6321
Country	:	US
Telephone Number	:	434-409-2578
Fax Number	:

Provider Business Practice Location Address
First Line	:	875 RIO EAST CT STE A
Second Line	:
City	:	CHARLOTTESVILLE
State	:	VA
Zip	:	22901-8050
Country	:	US
Telephone Number	:	434-409-2024
Fax Number	:

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

Provider Enumeration Date	:	01/17/2025
Last Update Date	:	01/17/2025

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