Matt Kevin Bulloch, L.P.C. NCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2785863-6004 Issued in UT

Practice address

2460 W Highway 56
#5
Cedar City, UT 84720-4118

Phone

(435) 327-2137

NPI assigned

Apr 23, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1208908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257897600000",
    "number": "1457526337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1009 IRONWOOD CIR",
            "city": "CEDAR CITY",
            "state": "UT",
            "postal_code": "847215125",
            "telephone_number": "435-327-2137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2460 W HIGHWAY 56",
            "address_2": "#5",
            "city": "CEDAR CITY",
            "state": "UT",
            "postal_code": "847204118",
            "telephone_number": "435-327-2137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLOCH",
        "first_name": "MATT",
        "middle_name": "KEVIN",
        "name_prefix": "Mr.",
        "credential": "L.P.C. NCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-23",
        "last_updated": "2009-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "UT",
            "license": "2785863-6004",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "2785863-6004",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bryan Haight D.D.S., Inc
• Kamryn Buchanan
• Ashley Sartini Buckner, LMFT
• John Curtis Buckner, LMFT
• Lily Bullen
• Micah J Bulloch, LCSW
• Michael Brent Bulloch, D.O.
• Clint O Bunker, DO
• Tani Dale Bunker
• Augustine Bunkley

• All providers in Cedar City, UT
• Professional Counselor in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2009; 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.