Provider Demographics
NPI:1013681659
Name:PULCINELLA, KARLY ROSE (LPC)
Entity Type:Individual
Prefix:
First Name:KARLY
Middle Name:ROSE
Last Name:PULCINELLA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8588 WISSAHICKON AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19128-1238
Mailing Address - Country:US
Mailing Address - Phone:215-620-7816
Mailing Address - Fax:
Practice Address - Street 1:8588 WISSAHICKON AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19128-1238
Practice Address - Country:US
Practice Address - Phone:215-620-7816
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-06
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC013570101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health