Active NPI
Dolores Jeanne Bullock, LPC
- Professional Counselor
- Jersey City, NJ
National Provider Identifier
1700527702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 37PC00827600
- Practice address
- 96 Linden Ave
Jersey City, NJ 07305-3919 - Phone
- (551) 208-8565
- NPI assigned
- Apr 5, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 37PC00827600 | NJ | Primary |
Addresses
Primary practice location
96 Linden Ave
Jersey City, NJ 07305-3919
Mailing address
96 Linden Ave
Jersey City, NJ 07305-3919
Phone (551) 208-8565
Other practice location 1
96 Linden Ave
Jersey City, NJ 07305-3919
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37PC00827600 | NJ | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1649116800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649116800000",
"number": "1700527702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "96 LINDEN AVE",
"city": "JERSEY CITY",
"state": "NJ",
"postal_code": "073053919",
"telephone_number": "551-208-8565"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "96 LINDEN AVE",
"city": "JERSEY CITY",
"state": "NJ",
"postal_code": "073053919",
"telephone_number": "551-208-8565"
}
],
"practiceLocations": [
{
"address_1": "96 Linden Ave",
"address_purpose": "LOCATION",
"city": "Jersey City",
"state": "NJ",
"postal_code": "073053919",
"country_code": "US",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BULLOCK",
"first_name": "DOLORES",
"middle_name": "JEANNE",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-04-05",
"last_updated": "2022-04-05",
"certification_date": "2022-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NJ",
"license": "37PC00827600",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jersey City, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.