MEDICARE: MRS. ERIN GULLETT

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	304724	KY

General Provider Information

NPI Number	:	1508711086
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ERIN GULLETT

Provider Business Mailing Address
First Line	:	1100 OUR LADY WAY
Second Line	:	STE 219
City	:	ASHLAND
State	:	KY
Zip	:	41101
Country	:	US
Telephone Number	:	606-388-4911
Fax Number	:	606-388-4913

Provider Business Practice Location Address
First Line	:	1100 OUR LADY WAY
Second Line	:	STE 219
City	:	ASHLAND
State	:	KY
Zip	:	41101
Country	:	US
Telephone Number	:	606-388-4911
Fax Number	:	606-388-4913

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

Provider Enumeration Date	:	03/02/2026
Last Update Date	:	03/02/2026

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