Dwight Evan Bull, LMSW

Key facts

NPI

1780801522

Entity type

Individual (NPI type 1)

Primary specialty

Clinical Social Worker 1041C0700X

License

6801033579 (MI)

Practice address

10495 Northland Dr
Big Rapids, MI 49307-8740

Phone

(231) 652-5459

NPI assigned

Apr 20, 2007

Sex

Male

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

Yes

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 28, 2016.

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482883200000",
    "number": "1780801522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 E BARTON ST",
            "city": "NEWAYGO",
            "state": "MI",
            "postal_code": "493378576",
            "telephone_number": "231-652-1370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10495 NORTHLAND DR",
            "city": "BIG RAPIDS",
            "state": "MI",
            "postal_code": "493078740",
            "telephone_number": "231-652-5459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULL",
        "first_name": "DWIGHT",
        "middle_name": "EVAN",
        "name_prefix": "Mr.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-20",
        "last_updated": "2016-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801033579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Brenda L Byl, COTA

All providers in Big Rapids, MI · Clinical Social Worker in Michigan