Provider Demographics
NPI:1497453880
Name:GULOTTA, MICHELE E (LMHC)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:E
Last Name:GULOTTA
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 PICADILLY ST
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-6017
Mailing Address - Country:US
Mailing Address - Phone:561-418-3272
Mailing Address - Fax:
Practice Address - Street 1:222 PICADILLY ST
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-6017
Practice Address - Country:US
Practice Address - Phone:561-418-3272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-16
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL19683101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health