Individual
DR. MICHELE LYNN BULLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NCC, LPC, BC-TMH
Contact information
Practice address
55 TENNYSON AVE, NORTH HAVEN, CT 06473-2732
(203) 868-5436
Mailing address
55 TENNYSON AVE, NORTH HAVEN, CT 06473-2732
(203) 868-5436
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
001538
CT
101YM0800X
Mental Health Counselor
TPMC5336
FL
101YP2500X
Professional Counselor
Primary
001538
CT
Other
Enumeration date
02/06/2007
Last updated
05/07/2026
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