Marisa Bullard, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6802088087 Issued in MI

Practice address

1830 Beech Ave
Mt Pleasant, MI 48858-1280

Phone

(231) 598-2040

NPI assigned

May 20, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Counseling Connections of Central Michigan

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mt Pleasant, MI
  • NPI 1124765235
  NPD Authorized official
• Community Mental Health for Central Michigan

  • Psychiatry Physician
  • Mt Pleasant, MI
  • NPI 1609412840

  Clinical

  NPD (past)
• Community Mental Health for Central Michigan

  • Psychiatry Physician
  • Mt Pleasant, MI
  • NPI 1881622892

  Clinical

  NPD (past)

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

{
    "created_epoch": "1400544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1124439534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1830 BEECH AVE",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "488581280",
            "telephone_number": "231-598-2040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1830 BEECH AVE",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "488581280",
            "telephone_number": "231-598-2040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLARD",
        "first_name": "MARISA",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-20",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6802088087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bryan Dental Smiles Group PLLC (Bryan Dental Smiles Group)
• F Allen Bryan, DDS
• Taylor Marie Bryant
• Liana Nicole Bucaro
• Dennis Milton Buck, M.S.
• Jenna Rosalyn Burgin
• Laura Burman
• Janice I Burton, MSW
• Emma Rose Buschlen
• Alissa Butts

• Clinical Social Worker in Mt Pleasant, MI
• Providers in Mt Pleasant, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2022; 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.