Larry G Bullard, MS

Individual provider Active NPI Mental Health Counselor · Moulton, AL

NPI 1013075845 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1013075845
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
317 Hospital St
Moulton, AL 35650-1269
Phone
(256) 355-6105
NPI assigned
Dec 5, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Center of North Central Alabama Inc. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Yes

Addresses

Primary practice location

317 Hospital St
Moulton, AL 35650-1269

Mailing address

1316 Somerville Rd SE
Suite 1
Decatur, AL 35601-4305

Other providers in Moulton, AL

All providers in Moulton, AL · Mental Health Counselor in Alabama

Sources for this page

Verify at the official NPI Registry.