Individual
CHARLES R. BULMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LADC, LPCC
Contact information
Practice address
4505 WHITE BEAR PKWY STE 1500, WHITE BEAR LAKE, MN 55110-3697
(651) 493-8150
(651) 493-9335
Mailing address
1426 SIMPSON ST, SAINT PAUL, MN 55108-2440
(612) 296-0348
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
303359
MN
101YM0800X
Mental Health Counselor
Primary
CC1392
MN
Other
Enumeration date
03/11/2014
Last updated
12/04/2019
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