Micah J Bulloch, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

8765778-3501 Issued in UT

Practice address

245 E 680 S
Cedar City, UT 84720-3593

Phone

(435) 867-7654

Fax

(435) 867-7699

NPI assigned

Sep 29, 2017

Last updated

Apr 7, 2026By 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 4

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

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

University of Utah School of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Roots Counseling and AssessmentsGroup PAC ID 8224484209, 3 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.

• Roots Counseling and Assessments

  • Mental Health Counselor
  • Cedar City, UT
  • NPI 1588172068
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1506643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775520000000",
    "number": "1679082952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2505 IDLEWILDE DR",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797076120",
            "telephone_number": "435-868-8405",
            "fax_number": "435-986-8700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 E 680 S",
            "city": "CEDAR CITY",
            "state": "UT",
            "postal_code": "847203593",
            "telephone_number": "435-867-7654",
            "fax_number": "435-867-7699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLOCH",
        "first_name": "MICAH",
        "middle_name": "J",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-29",
        "last_updated": "2026-04-07",
        "certification_date": "2026-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "107800",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "8371889",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "8765778-3501",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "UT",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kamryn Buchanan
• Ashley Sartini Buckner, LMFT
• John Curtis Buckner, LMFT
• Lily Bullen
• Matt Kevin Bulloch, L.P.C. NCC
• Michael Brent Bulloch, D.O.
• Clint O Bunker, DO
• Tani Dale Bunker
• Augustine Bunkley
• Brian N Burrows, MD

• Clinical Social Worker in Cedar City, UT
• Providers in Cedar City, UT by specialty
• Clinical Social Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2026; 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.