Shawn A. Bultsma, PHD, LPC, NCC
Individual provider Active NPI Professional Counselor · Soldotna, AK
NPI 1225112493 · NPPES record last updated Jan 3, 2024
Key facts
- NPI
- 1225112493
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 197538 (AK)
- Practice address
- 33880 Community College Dr Ste 1
Soldotna, AK 99669-9234 - Phone
- (616) 745-4637
- NPI assigned
- Oct 24, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 197538 | AK | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 197538 | AK | Yes |
Addresses
Primary practice location
33880 Community College Dr Ste 1
Soldotna, AK 99669-9234
Mailing address
33880 Community College Dr Ste 1
Soldotna, AK 99669-9234
Phone (616) 745-4637
Other providers in Soldotna, AK
- Shari Le Bryant-Conner
- Shae Le Kathleen Bryant
- Carole Buchholz
- Curtis L Buchholz
- Christa Buckley
- Ciarra Kristine Burdick
- Shera Burg
- Eric K Burke
- Taylor N Burke
- Ian Burtenshaw
All providers in Soldotna, AK · Professional Counselor in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 3, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.