Tara A Bulko, MA, LPC, NCC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

6401224519 Issued in MI

Practice address

5340 Holiday Ter
Kalamazoo, MI 49009-2196

Phone

(269) 372-4140

NPI assigned

Jul 7, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tara.bulko.1@28621.direct.athenahealth.com

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

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  • NPI 1922860170
  NPD
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  • Clinical Social Worker
  • De Pere, WI
  • NPI 1396622494
  NPD

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

{
    "created_epoch": "1657152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1992438931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 ROTHBURY ST",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490243145",
            "telephone_number": "269-352-5684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5340 HOLIDAY TER",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490092196",
            "telephone_number": "269-372-4140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULKO",
        "first_name": "TARA",
        "middle_name": "A",
        "credential": "MA, LPC, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-07",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401224519",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6451022318",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LARA",
            "identifier": "6451022318",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LARA",
            "identifier": "6401224519",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brandon William Buell, PHARM.D.
• Melanie Lynn Bugnaski, LPC
• Anita Joy Buitenwerf, NP
• Ibrahim Muhammad Bulama, MD
• Arna Buljko, DNP, AGNP-C
• Starr Bull
• Teri Bullard
• Elizabeth Bullmer, C.M.T.
• Samuel J Bultman, LPC
• Jennifer Bultsma

• Counselor in Kalamazoo, MI
• Providers in Kalamazoo, MI by specialty
• Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.