Active NPI
Jacqueline Bullock
- School Psychologist
- Midlothian, VA
National Provider Identifier
1720581978
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 0813000924
- Practice address
- 13900 Hull Street Rd
Midlothian, VA 23112-2004 - Phone
- (804) 639-8788
- NPI assigned
- Mar 14, 2018
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 0813000924 | VA | Primary |
Addresses
Primary practice location
13900 Hull Street Rd
Midlothian, VA 23112-2004
Mailing address
13900 Hull Street Rd
Midlothian, VA 23112-2004
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 |
|---|---|---|---|
| 0813000924 | VA | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1520985600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1520985600000",
"number": "1720581978",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13900 HULL STREET RD",
"city": "MIDLOTHIAN",
"state": "VA",
"postal_code": "231122004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13900 HULL STREET RD",
"city": "MIDLOTHIAN",
"state": "VA",
"postal_code": "231122004",
"telephone_number": "804-639-8788"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BULLOCK",
"first_name": "JACQUELINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-03-14",
"last_updated": "2018-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "VA",
"license": "0813000924",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Midlothian, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.