Nicole Wright Bullock, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

ISW02480 Issued in RI

Practice address

55 Hope St
Providence, RI 02906-2001

Phone

(401) 331-1350

Fax

(401) 277-3366

NPI assigned

May 22, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1337644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424217600000",
    "number": "1699035808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 THURBERS AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029054754",
            "telephone_number": "401-331-1350",
            "fax_number": "401-277-3366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 HOPE ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029062001",
            "telephone_number": "401-331-1350",
            "fax_number": "401-277-3366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "NICOLE",
        "middle_name": "WRIGHT",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-22",
        "last_updated": "2015-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "CSW01357",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "ISW02480",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF RHODE ISLAND AND PROVIDENCE PLANTATIONS DEPARTMENT OF HEALTH",
            "identifier": "CSW01357",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF RI",
            "identifier": "ISW02480",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ariane Buffum, OTA
• Ruth Bugbee, RN
• Amanda Ellen Buglio, M.S.
• Danny Duc Bui, MD
• Catherine Bukspan, OD
• Jonathan Buma, OD
• Gail Evelyn Bunce, ADULT NP, BC
• Ashley E Bunker, LMHC
• Vesna Buntak, MD
• Evelyn M Buonaiuto, R.N.,CDOE

• Clinical Social Worker in Providence, RI
• Providers in Providence, RI by specialty
• Clinical Social Worker in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2015; 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.