Madeline Bullock

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

2802 145TH St W
Rosemount, MN 55068-4940

Phone

(651) 387-0616

NPI assigned

Dec 20, 2023

Last updated

Dec 20, 2023By the provider in NPPES

Sex

Female

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

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

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.

• Life Development Resources, PA

  • Community/Behavioral Health Agency
  • Lakeville, MN
  • NPI 1902953169

  Professional

  Medicare reassignment NPD

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

{
    "created_epoch": "1703030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1427827310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2802 145TH ST W",
            "city": "ROSEMOUNT",
            "state": "MN",
            "postal_code": "550684940",
            "telephone_number": "651-387-0616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2802 145TH ST W",
            "city": "ROSEMOUNT",
            "state": "MN",
            "postal_code": "550684940",
            "telephone_number": "651-387-0616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "MADELINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-20",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph 'Skip' Clemens Arvin Brenny, LMFT
• Andrea Britt
• Alexandra Louise Brooks
• Kristy Brouchet
• Christa Bruessel, MA
• Riley Burke
• Emily Jane Calhoon, MA
• Cameo Dental, P.a.
• Gabrielle Ann Canessa
• Thomas Caravello

• Professional Counselor in Rosemount, MN
• Providers in Rosemount, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.