Provider Demographics
NPI:1538431044
Name:VULKASINOVICH & ASSOCIATES, LLC
Entity type:Organization
Organization Name:VULKASINOVICH & ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:VULKASINOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:MSED
Authorized Official - Phone:937-369-3020
Mailing Address - Street 1:4134 LINDEN AVENUE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45432-3035
Mailing Address - Country:US
Mailing Address - Phone:937-369-3020
Mailing Address - Fax:937-254-2117
Practice Address - Street 1:4134 LINDEN AVENUE
Practice Address - Street 2:SUITE 200
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45432-3035
Practice Address - Country:US
Practice Address - Phone:937-369-3020
Practice Address - Fax:937-254-2117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-30
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE3246101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty