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Individual

JEREMIAH BULLARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPCA

Contact information

Practice address
113 BARTON MILL RD APT 2H, CORBIN, KY 40701-2921
(606) 627-3595
(606) 385-1853
Mailing address
113 BARTON MILL RD APT 2H, CORBIN, KY 40701-2921
(606) 627-3595
(606) 385-1853

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
101YP2500X
Professional Counselor
Primary
304165
KY

Other

Enumeration date
08/30/2021
Last updated
04/17/2026
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