Individual
KELLY BATES ULLMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
9030 ANTARES AVE, SUITE B1, COLUMBUS, OH 43240
(614) 505-0091
(614) 505-0077
Mailing address
9030 ANTARES AVE, SUITE B1, COLUMBUS, OH 43240
(614) 505-0091
(614) 505-0077
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
E.2505125
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
E.2505125
OH
101YP2500X
Professional Counselor
Primary
E.2505125
OH
Other
Enumeration date
08/21/2025
Last updated
04/19/2026
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