Scott K Bullock, MSW, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I 0008810-S Issued in OH

Practice address

700 E 1St St
Dayton, OH 45402-1303

Phone

(937) 641-4040

Fax

(937) 641-3066

NPI assigned

Feb 27, 2009

Last updated

Oct 7, 2023By 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

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

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Neuropsych Center of Greater Cincinnati LLCGroup PAC ID 2567754815, 17 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.

• Neuropsych Center of Greater Cincinnati LLC

  • Clinical Neuropsychologist
  • Cincinnati, OH
  • NPI 1801241237
  Medicare reassignment Care Compare group NPD
• Dayton Children's Hospital

  • Child & Adolescent Psychiatry Physician
  • Dayton, OH
  • NPI 1952480030

  Clinical

  Medicare reassignment NPD
• Dayton Children's Hospital

  • Urgent Care Clinic/Center
  • Miamisburg, OH
  • NPI 1730392309
  NPD
• Neuropsych Center of Greater Cincinnati LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Cincinnati, OH
  • NPI 1164238150
  NPD
• Neuropsych Center of Greater Cincinnati

  • Clinical Psychologist
  • Fort Thomas, KY
  • NPI 1790222065
  NPD (past)

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

{
    "created_epoch": "1235692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696636800000",
    "number": "1326288507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 933421",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441930039",
            "telephone_number": "937-641-5072",
            "fax_number": "937-641-6129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 E 1ST ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454021303",
            "telephone_number": "937-641-4040",
            "fax_number": "937-641-3066"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "76 Remick Blvd",
            "address_purpose": "LOCATION",
            "city": "Springboro",
            "state": "OH",
            "postal_code": "450669168",
            "country_code": "US",
            "telephone_number": "937-641-4040",
            "fax_number": "937-641-3066",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "333 W Tech Rd.",
            "address_purpose": "LOCATION",
            "city": "Miamisburg",
            "state": "OH",
            "postal_code": "453420955",
            "country_code": "US",
            "telephone_number": "937-641-4040",
            "fax_number": "937-641-3066",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Childrens Plz",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454041815",
            "country_code": "US",
            "telephone_number": "937-641-4040",
            "fax_number": "937-641-3066",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "SCOTT",
        "middle_name": "K",
        "name_prefix": "Mr.",
        "credential": "MSW,  LISW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-02-27",
        "last_updated": "2023-10-07",
        "certification_date": "2023-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I 0008810-S",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0002716",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ali Abbas Bukhari, M.D.
• Alexis Bukuru
• Cynthia Bullard
• John Bullmaster
• Ashley Bullock
• Hannah Bultemeier
• Alyssa Bunch, RN
• Toni Marie Bunch, LCDC II
• Joshua Bundy, ATC
• Mounica Burada

• Clinical Social Worker in Dayton, OH
• Providers in Dayton, 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 Oct 7, 2023; 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.