Active NPI
Alexandra Sowden Bullock, LCSW
- Clinical Social Worker
- Philadelphia, PA
National Provider Identifier
1780305599
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CW020377
- Practice address
- 3500 Civic Center Blvd
Philadelphia, PA 19104-4395 - Phone
- (215) 590-1000
- NPI assigned
- Sep 9, 2022
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CW020377 | PA | Primary |
Addresses
Primary practice location
3500 Civic Center Blvd
Philadelphia, PA 19104-4395
Mailing address
352 Lenape LN
Chalfont, PA 18914-3142
Phone (267) 261-1803
Other practice location 1
500 W Butler Ave
Chalfont, PA 18914-2219
Phone (215) 997-5730
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215921457 | Medicaid | PA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | securerecords.chop.edu | Health Information Exchange (HIE) |
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 |
|---|---|---|---|
| CW020377 | PA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1662681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662681600000",
"number": "1780305599",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "352 LENAPE LN",
"city": "CHALFONT",
"state": "PA",
"postal_code": "189143142",
"telephone_number": "267-261-1803"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3500 CIVIC CENTER BLVD",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191044395",
"telephone_number": "215-590-1000"
}
],
"practiceLocations": [
{
"address_1": "500 W Butler Ave",
"address_purpose": "LOCATION",
"city": "Chalfont",
"state": "PA",
"postal_code": "189142219",
"country_code": "US",
"telephone_number": "215-997-5730",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BULLOCK",
"first_name": "ALEXANDRA",
"middle_name": "SOWDEN",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-09",
"last_updated": "2022-09-09",
"certification_date": "2022-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "PA",
"license": "CW020377",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1215921457",
"state": "PA"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "securerecords.chop.edu",
"affiliation": "N",
"endpointDescription": "CHOP",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "N/A",
"address_1": "3500 Civic Center Blvd",
"city": "Philadelphia",
"state": "PA",
"country_code": "US",
"postal_code": "191044395",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 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.