Michael Bullock, LISW-S

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.0008730 Issued in OH

Practice address

150 Cross St
Akron, OH 44311-1026

Phone

(330) 996-9141

Fax

(330) 253-0377

NPI assigned

Nov 19, 2015

Last updated

Nov 19, 2015By 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 1

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Support Services, IncGroup PAC ID 7911993415, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Community Support Services, Inc

  • Primary Care Clinic/Center
  • Akron, OH
  • NPI 1457505968
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1447891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447891200000",
    "number": "1295109890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 CROSS ST",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443111026",
            "telephone_number": "330-996-9141",
            "fax_number": "330-253-0377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 CROSS ST",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443111026",
            "telephone_number": "330-996-9141",
            "fax_number": "330-253-0377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "MICHAEL",
        "credential": "LISW-S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-19",
        "last_updated": "2015-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.0008730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LISW-S",
            "identifier": "I.0008730",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kenneth A. Bulen, MD
• Mary Therese Bulford, RN, CNP
• Audra Lee Bulgrin
• Trina Bullard
• Keaton Michael Bullen, D.O.
• Timothy E Bunchman, MD
• Rachael Bunner
• Alexandria Avril Burch, PT, DPT
• Breyana Jequei Burch
• Fletcher Gordon Burch

• Clinical Social Worker in Akron, OH
• Providers in Akron, 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 Nov 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.