James Howard Bullock, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810001604 Issued in VA

Practice address

9097 Atlee Station Rd
Suite 219
Mechanicsville, VA 23116-2525

Phone

(804) 730-2829

Fax

(804) 730-2829

NPI assigned

Aug 1, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Commonwealth Counseling Associates Inc

  dba LifeStance Health

  • Clinical Psychologist
  • Mechanicsville, VA
  • NPI 1851345805
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104832815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9097 ATLEE STATION RD",
            "address_2": "SUITE 219",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231162525",
            "telephone_number": "804-730-2829",
            "fax_number": "804-730-2829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9097 ATLEE STATION RD",
            "address_2": "SUITE 219",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231162525",
            "telephone_number": "804-730-2829",
            "fax_number": "804-730-2829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "JAMES",
        "middle_name": "HOWARD",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810001604",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7705077",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "440242",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Corey Bryant, DC
• Jessie Lee Bryant
• BSMH Employer Services LLC (Bon Secours Occupational Health)
• Esther H Bucher, MS OTR L
• Kathryn Gunter Buhse, FNP-BC
• Andrew Gordon Burcham, FNP-BC
• Julie Marie Burcham, LCSW
• Christy Scott Burke-Peyton, RN,ANP
• Michelle Burke, LPC
• Jason Burkhead, LPC

• Clinical Psychologist in Mechanicsville, VA
• Providers in Mechanicsville, VA by specialty
• Clinical Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.