Provider Demographics
NPI:1740506500
Name:BULPIN, RANDOLPH JAMES (MA)
Entity type:Individual
Prefix:MR
First Name:RANDOLPH
Middle Name:JAMES
Last Name:BULPIN
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 71
Mailing Address - Street 2:
Mailing Address - City:HARDWICK
Mailing Address - State:VT
Mailing Address - Zip Code:05843-0071
Mailing Address - Country:US
Mailing Address - Phone:802-535-6160
Mailing Address - Fax:
Practice Address - Street 1:144 S MAIN ST
Practice Address - Street 2:
Practice Address - City:HARDWICK
Practice Address - State:VT
Practice Address - Zip Code:05843-7046
Practice Address - Country:US
Practice Address - Phone:802-535-6160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-19
Last Update Date:2023-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT068.0057724101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health