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General NPI Number Information
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NPI Number | 1023818663
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Entity Type | Individual
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Provider Name | KSENIYA BULAT LMSW
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Gender | Female
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Dates
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Enumeration Date | 03/13/2025
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Last Update Date | 02/02/2026
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Provider Practice Location Address
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Address Line | 119 MAPLE AVE
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City | RED BANK
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State | NJ
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Zip | 07701-1764
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Country | US
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Telephone | 647-704-3054
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Fax |
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Provider Business Mailing Address
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Address Line | 320 W 38TH ST APT 2506
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City | NEW YORK
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State | NY
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Zip | 10018-5241
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Country | US
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Telephone | 647-704-3054
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | SW142704
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 44SL07251200
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 129960
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License Number State | NY
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