MEDICARE: MRS. KELLY M. BULINSKI MSED., LPCC-S

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	101YP2500X	Professional Counselor	C0800364	OH

General Provider Information

NPI Number	:	1740506690
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KELLY M. BULINSKI MSED., LPCC-S

Provider Business Mailing Address
First Line	:	5556 ROYAL POINTE DR
Second Line	:
City	:	DUBLIN
State	:	OH
Zip	:	43016-7517
Country	:	US
Telephone Number	:	614-551-9297
Fax Number	:	614-848-5323

Provider Business Practice Location Address
First Line	:	161 S LIBERTY ST
Second Line	:
City	:	POWELL
State	:	OH
Zip	:	43065-7619
Country	:	US
Telephone Number	:	614-551-9297
Fax Number	:	614-848-5323

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

Provider Enumeration Date	:	04/18/2010
Last Update Date	:	09/21/2019

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