Active NPI
Liamara Bullock, AA, CPSS
- Peer Specialist
- Longview, WA
National Provider Identifier
1073223665
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- PR70110892
- Practice address
- 1400 Commerce Ave
Longview, WA 98632-3756 - Phone
- (360) 998-2047
- Fax
- (360) 200-6736
- NPI assigned
- Dec 5, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 61377319 | WA | |
| Peer Specialist | 175T00000X | PR70110892 | WA | Primary |
Addresses
Primary practice location
1400 Commerce Ave
Longview, WA 98632-3756
Mailing address
PO Box 2394
Longview, WA 98632-8455
Phone (360) 200-5419
Other practice location 1
748 14th Ave
Longview, WA 98632-2315
Phone (360) 200-5419
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 61377319 | WA | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Core Health | Past | Accepting new patients |
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Longview, WA
- NPI 1639693781
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1670198400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787529600000",
"number": "1073223665",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2394",
"city": "LONGVIEW",
"state": "WA",
"postal_code": "986328455",
"telephone_number": "360-200-5419",
"fax_number": "944-612-6673"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 COMMERCE AVE",
"city": "LONGVIEW",
"state": "WA",
"postal_code": "986323756",
"telephone_number": "360-998-2047",
"fax_number": "360-200-6736"
}
],
"practiceLocations": [
{
"address_1": "748 14th Ave",
"address_purpose": "LOCATION",
"city": "Longview",
"state": "WA",
"postal_code": "986322315",
"country_code": "US",
"telephone_number": "360-200-5419",
"fax_number": "844-612-6673",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BULLOCK",
"first_name": "LIAMARA",
"credential": "AA, CPSS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-12-05",
"last_updated": "2026-08-24",
"certification_date": "2026-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "WA",
"license": "61377319",
"primary": false
},
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "WA",
"license": "PR70110892",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Longview, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.