Individual provider Active NPI

Cindy Bullard, LPC ASSOCIATE

  • Professional Counselor
  • Crandall, TX
National Provider Identifier
1396489977
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
86514 Issued in TX
Practice address
2016 Ocelot St
Crandall, TX 75114-0106
Phone
(972) 275-9632
NPI assigned
Apr 21, 2022
Last updated
Jan 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 86514 TX Primary

Addresses

Primary practice location

2016 Ocelot St
Crandall, TX 75114-0106

Mailing address

2016 Ocelot St
Crandall, TX 75114-0106
Phone (972) 275-9632

Other practice location 1

5300 University Hills Blvd
Dallas, TX 75241-1219
Phone (214) 941-3500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20240503001296 TX Practitioner - Mental Health Counselor 8325488620 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
North Texas Behavioral Health Authority Professional CurrentSince Jul 26, 2024 Accepting new patients
Hill Psychological Services, PLLC Multi-Specialty CurrentSince Apr 1, 2024 Accepting new patients
North Texas Behavioral Health Authority Professional PastSince Apr 24, 2022 Accepting new patients

Locations

5300 University Hills Blvd
Dallas, TX 75241
Phone (214) 941-3500

8111 Lyndon B Johnson Fwy
Ste 900
Dallas, TX 75251
Phone (214) 366-9407

1452 Hughes Rd
Ste 200
Grapevine, TX 76051
Phone (817) 410-5721

108 W Grove St
Kaufman, TX 75142
Phone (214) 366-9407

99 Trophy Club Dr
Trophy Club, TX 76262
Phone (817) 430-5805

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1650499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1396489977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2016 OCELOT ST",
            "city": "CRANDALL",
            "state": "TX",
            "postal_code": "751140106",
            "telephone_number": "972-275-9632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2016 OCELOT ST",
            "city": "CRANDALL",
            "state": "TX",
            "postal_code": "751140106",
            "telephone_number": "972-275-9632"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5300 University Hills Blvd",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752411219",
            "country_code": "US",
            "telephone_number": "214-941-3500",
            "fax_number": "214-389-1084",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BULLARD",
        "first_name": "CINDY",
        "credential": "LPC ASSOCIATE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-21",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "86514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crandall, TX

Sources for this page

Verify at the official NPI Registry.