Stephen J Bullock, CDCA.192853

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CDCA.192853 Issued in OH

Practice address

7593 Tylers Place Blvd
West Chester, OH 45069-6308

Phone

(513) 714-3400

NPI assigned

Jul 17, 2025

Last updated

Jul 17, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

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

{
    "created_epoch": "1752710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752710400000",
    "number": "1235021908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 LORI LN",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454492610",
            "telephone_number": "937-979-5243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7593 TYLERS PLACE BLVD",
            "city": "WEST CHESTER",
            "state": "OH",
            "postal_code": "450696308",
            "telephone_number": "513-714-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "STEPHEN",
        "middle_name": "J",
        "credential": "CDCA.192853",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-07-17",
        "last_updated": "2025-07-17",
        "certification_date": "2025-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "CDCA.192853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James W Buckreus, M.D.
• Christopher Bueker, LCDC III
• Marie Susan Cabreros Buenavides
• Denis Chuo Buh
• Thom Bui, PHARM.D
• Courtney Michelle Burbrink, DPT, PT
• Taylor Burgan, DO
• Robert E Buring, MD
• Jason Charles Burkart
• Emily Michelle Burkhart, MA, LPC

• Clinical Social Worker in West Chester, OH
• Providers in West Chester, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2025; 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.