MEDICARE: DR. MICHELE LYNN BULLOCK NCC, LPC, BC-TMH

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	TPMC5336	FL
2	101YP2500X	Professional Counselor	001538	CT
3	101YM0800X	Mental Health Counselor	001538	CT

General Provider Information

NPI Number	:	1376682161
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHELE LYNN BULLOCK NCC, LPC, BC-TMH

Provider Business Mailing Address
First Line	:	55 TENNYSON AVE
Second Line	:
City	:	NORTH HAVEN
State	:	CT
Zip	:	06473-2732
Country	:	US
Telephone Number	:	203-868-5436
Fax Number	:

Provider Business Practice Location Address
First Line	:	55 TENNYSON AVE
Second Line	:
City	:	NORTH HAVEN
State	:	CT
Zip	:	06473-2732
Country	:	US
Telephone Number	:	203-868-5436
Fax Number	:

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

Provider Enumeration Date	:	02/06/2007
Last Update Date	:	05/07/2026

Similar Medicare Providers

1174285522 — CYNTHIA CANALES LCSW
Practice Location Address:

1 BUCKEYE CIR NE
WINTER HAVEN, FL
33881-2732

Practice Phone: 863-224-7174
Practice Fax:

1689429946 — LIBERTY PHARMACY INC
Practice Location Address:

886 CAMPBELL AVE
WEST HAVEN, CT
06516-2732

Practice Phone: 475-766-5454
Practice Fax:

1881671212 — HEALTHCARE SERVICES INC
Practice Location Address:

219 NORTH AVE , STE 201
LA FOLLETTE, TN
37766-2732

Practice Phone: 423-566-1314
Practice Fax: 423-566-2466

1285611350 — DR. DAVID EVANS HANSON PHD
Practice Location Address:

219 NORTH AVE , STE 201
LA FOLLETTE, TN
37766-2732

Practice Phone: 423-566-1314
Practice Fax: 423-566-2466

1073590147 — MS. CAROL ANN MARSHALL APRN BC PSYCH NP
Practice Location Address:

219 NORTH AVE , STE 201, HEALTHCARE SERVICES INC
LA FOLLETTE, TN
37766-2732

Practice Phone: 423-566-1314
Practice Fax: 423-566-2466

1982632576 — MICHAEL DANA MCINTOSH PT
Practice Location Address:

14899 TAMIAMI TRL STE 200
NORTH PORT, FL
34287-2732

Practice Phone: 561-688-1844
Practice Fax: 561-688-1845

Directions to “ DR. MICHELE LYNN BULLOCK NCC, LPC, BC-TMH” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.