Gizelle Marie Bullock, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

004799 Issued in NY

Practice address

76 Lisbon St
Heuvelton, NY 13654-3130

Phone

(315) 244-0244

Fax

(315) 254-2811

NPI assigned

Apr 27, 2012

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 NY

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

Mental Health Counselor

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Citizen Advocates, IncGroup PAC ID 0648241976, 50 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 and National Provider Directory roles.

• Citizen Advocates, Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Malone, NY
  • NPI 1780619064
  Medicare reassignment Care Compare group NPD
• Citizen Advocates, Inc

  • Mental Illness Community Based Residential Treatment Facility
  • Malone, NY
  • NPI 1477765733
  NPD

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

{
    "created_epoch": "1335484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695340800000",
    "number": "1710245758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 LISBON ST",
            "city": "HEUVELTON",
            "state": "NY",
            "postal_code": "136543130",
            "telephone_number": "315-244-0244",
            "fax_number": "315-254-2811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 LISBON ST",
            "city": "HEUVELTON",
            "state": "NY",
            "postal_code": "136543130",
            "telephone_number": "315-244-0244",
            "fax_number": "315-254-2811"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1003 Park St",
            "address_purpose": "LOCATION",
            "city": "Ogdensburg",
            "state": "NY",
            "postal_code": "136693911",
            "country_code": "US",
            "telephone_number": "315-713-9090",
            "fax_number": "315-713-9330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "GIZELLE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-27",
        "last_updated": "2023-09-22",
        "certification_date": "2023-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "004799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carthage Area Hospital Inc
• Claxton Hepburn Medical Center
• Rene Green, LMT
• Marilynn Jane Harper, LPN
• Heuvelton Central School

• Mental Health Counselor in Heuvelton, NY
• Providers in Heuvelton, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 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.
• 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.