| Bulmahn Counseling Services Llc | |
|
2422 Lake Ave Fort Wayne IN 46805-5406 | |
| (260) 255-6376 | |
| Not Available |
| Full Name | Bulmahn Counseling Services Llc |
|---|---|
| Speciality | Social Worker |
| Location | 2422 Lake Ave, Fort Wayne, Indiana |
| Authorized Official Name and Position | Jill Bulmahn (OWNER) |
| Authorized Official Contact | 2602556376 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bulmahn Counseling Services Llc 2422 Lake Ave Fort Wayne IN 46805-5406 Ph: (260) 255-6376 | Bulmahn Counseling Services Llc 2422 Lake Ave Fort Wayne IN 46805-5406 Ph: (260) 255-6376 |
| NPI Number | 1730821356 |
|---|---|
| Provider Enumeration Date | 04/13/2022 |
| Last Update Date | 04/13/2022 |
| Certification Date | 04/11/2022 |
| Medicare PECOS PAC ID | 3375917891 |
|---|---|
| Medicare Enrollment ID | O20230324001365 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730821356 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jill Bulmahn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285113092 PECOS PAC ID: 4284008707 Enrollment ID: I20230324001452 |
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