MEDICARE: VALERIE BULL LMHC

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	005998	NY

General Provider Information

NPI Number	:	1578853016
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VALERIE BULL LMHC

Provider Business Mailing Address
First Line	:	3015 QUENTIN RD # 2F
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-4232
Country	:	US
Telephone Number	:	718-788-0280
Fax Number	:

Provider Business Practice Location Address
First Line	:	2541 E 19TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-3519
Country	:	US
Telephone Number	:	917-340-2397
Fax Number	:

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

Provider Enumeration Date	:	04/18/2011
Last Update Date	:	04/28/2015

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