Charles Martin Bullard, LICSW

Primary specialty

PsychoanalystTaxonomy code 102L00000X

License

020704-LW00006183 Issued in WA

Practice address

2206 Queen Anne Ave N
#203
Seattle, WA 98109-2370

Phone

(206) 283-4360

NPI assigned

May 7, 2007

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 names 1

• Mr. C Martin Bullard Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174736334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2206 QUEEN ANNE AVE N",
            "address_2": "#203",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981092370",
            "telephone_number": "206-283-4360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2206 QUEEN ANNE AVE N",
            "address_2": "#203",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981092370",
            "telephone_number": "206-283-4360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLARD",
        "first_name": "CHARLES",
        "middle_name": "MARTIN",
        "name_prefix": "Mr.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "102L00000X",
            "taxonomy_group": "",
            "desc": "Psychoanalyst",
            "state": "WA",
            "license": "020704-LW00006183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "C",
            "last_name": "BULLARD",
            "middle_name": "MARTIN",
            "prefix": "MR.",
            "credential": "LICSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Megan Bulger
• Molly McKelvey Bulger, LMT
• Catherine Velazquez Bull, ARNP
• Rebecca Bergman Bull, LAC
• Jonathan Gustav Bulla, MD
• Jenna M Buller Nofziger, ARNP
• Casey L Buller, CRNA
• Kimberly Buller, ARNP
• Kenda Dee Bulley, ARNP
• Eileen Bullinger, RN, MS

• Psychoanalyst in Seattle, WA
• Providers in Seattle, WA by specialty
• Psychoanalyst in Washington

• 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.