Active NPI
Jeremiah Bullard, LPCA
- Professional Counselor
- Corbin, KY
National Provider Identifier
1801563556
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 304165
- Practice address
- 113 Barton Mill Rd Apt 2H
Corbin, KY 40701-2921 - Phone
- (606) 627-3595
- Fax
- (606) 385-1853
- NPI assigned
- Aug 30, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 304165 | KY | Primary |
Addresses
Primary practice location
113 Barton Mill Rd Apt 2H
Corbin, KY 40701-2921
Mailing address
113 Barton Mill Rd Apt 2H
Corbin, KY 40701-2921
Phone (606) 627-3595
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 304165 | KY | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1630281600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776384000000",
"number": "1801563556",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "113 BARTON MILL RD APT 2H",
"city": "CORBIN",
"state": "KY",
"postal_code": "407012921",
"telephone_number": "606-627-3595",
"fax_number": "606-385-1853"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "113 BARTON MILL RD APT 2H",
"city": "CORBIN",
"state": "KY",
"postal_code": "407012921",
"telephone_number": "606-627-3595",
"fax_number": "606-385-1853"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BULLARD",
"first_name": "JEREMIAH",
"credential": "LPCA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-08-30",
"last_updated": "2026-04-17",
"certification_date": "2026-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Professional",
"state": "KY",
"license": "304165",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corbin, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.