Charles R. Bulman, LADC, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CC1392 Issued in MN

Practice address

4505 White Bear Pkwy Ste 1500
White Bear Lake, MN 55110-3697

Phone

(651) 493-8150

Fax

(651) 493-9335

NPI assigned

Mar 11, 2014

Last updated

Dec 4, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2013

Medicare assignment

May accept Medicare assignment

Group practices

Alliance for Healing PAGroup PAC ID 3173832722, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Alliance for Healing PA

  dba AHeARTT

  • Clinical Social Worker
  • White Bear Lake, MN
  • NPI 1275967374

  Mental Health

  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1394496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575417600000",
    "number": "1205252558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1426 SIMPSON ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551082440",
            "telephone_number": "612-296-0348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4505 WHITE BEAR PKWY STE 1500",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551103697",
            "telephone_number": "651-493-8150",
            "fax_number": "651-493-9335"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1315 Penn Avenue North",
            "address_2": "Northpoint Health and Wellness, Inc.",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "55411",
            "country_code": "US",
            "telephone_number": "612-767-9157",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "714 Park Ave.",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "55404",
            "country_code": "US",
            "telephone_number": "612-954-2000",
            "fax_number": "612-594-2030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BULMAN",
        "first_name": "CHARLES",
        "middle_name": "R.",
        "credential": "LADC, LPCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-03-11",
        "last_updated": "2019-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "303359",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "CC1392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alison Brunmeier
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• Kylie Yabanse Buck
• Neal C Buddensiek
• Carolyn Burchfield, M.A. CCC-SLP
• Savannah Grace Burnside, PHARMD
• Jessica Burton, DC
• Kelly Jill Cadmus, MASSAGE THERAPIST
• Calm Haven LLC

• Mental Health Counselor in White Bear Lake, MN
• Providers in White Bear Lake, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.