=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740506690
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KELLY M. BULINSKI MSED., LPCC-S
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/18/2010
-----------------------------------------------------
Last Update Date | 09/21/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 161 S LIBERTY ST
-----------------------------------------------------
City | POWELL
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43065-7619
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 614-551-9297
-----------------------------------------------------
Fax | 614-848-5323
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5556 ROYAL POINTE DR
-----------------------------------------------------
City | DUBLIN
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43016-7517
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 614-551-9297
-----------------------------------------------------
Fax | 614-848-5323
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | C0800364
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------