Healthcare Provider Details

I. General information

NPI: 1558945584
Provider Name (Legal Business Name): VICTORIA M KABUNGULU APPELGATE LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2021
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 MERCHANT ST
SPRINGDALE OH
45246-3735
US

IV. Provider business mailing address

135 MERCHANT ST
SPRINGDALE OH
45246-3735
US

V. Phone/Fax

Practice location:
  • Phone: 513-676-3777
  • Fax:
Mailing address:
  • Phone: 513-676-3777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number285254
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberE.2607076
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: