Da'Twanya Bullock

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

405 Parkway St Ste a
Greensboro, NC 27401-1693

Phone

(919) 985-0510

NPI assigned

Sep 22, 2022

Last updated

Sep 22, 2022By the provider in NPPES

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

Practice roles

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.

• Alexander Youth Network

  • Community/Behavioral Health Agency
  • Charlotte, NC
  • NPI 1518060318
  NPD (past)

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

{
    "created_epoch": "1663804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663804800000",
    "number": "1366165599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6220 THERMAL RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282115630",
            "telephone_number": "704-366-8712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 PARKWAY ST STE A",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011693",
            "telephone_number": "919-985-0510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "DA'TWANYA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-22",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaitlyn Elisabeth Bullard
• Karleigh Bullard, DDS
• Sarah Grace Bullard, NP
• Kaylee Bullin Matthews, SLP
• Sydney Crutchfield Bullins, LPCA
• Harriet Bullock, MS, LMFT
• Jada Bullock
• Jillian Bullock, REGISTERED NURSE
• Bullseye Enterprises, Inc.
• Hdin Bulu, RN

• Clinical Social Worker in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 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.