Healthcare Provider Details

I. General information

NPI: 1326931569
Provider Name (Legal Business Name): AMBER LEE KULE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2025
Last Update Date: 05/29/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

282 CENTRAL ST
ACTON MA
01720-4790
US

IV. Provider business mailing address

17 HART PL
WOBURN MA
01801-2354
US

V. Phone/Fax

Practice location:
  • Phone: 978-472-0224
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLMHC10002080
License Number StateMA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: