Provider Demographics
NPI:1700590650
Name:ELIZABETH W BULMER COUNSELING LLC
Entity type:Organization
Organization Name:ELIZABETH W BULMER COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:WALT
Authorized Official - Last Name:BULMER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:832-298-1763
Mailing Address - Street 1:1601 S STATE ST STE 100
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-3507
Mailing Address - Country:US
Mailing Address - Phone:405-252-1203
Mailing Address - Fax:
Practice Address - Street 1:1601 S STATE ST STE 100
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-3507
Practice Address - Country:US
Practice Address - Phone:405-252-1203
Practice Address - Fax:405-267-4742
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-05
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Single Specialty