Abigail Rose Lei Bullock

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

C10900 Issued in OR

Practice address

4531 SE Belmont St Ste 317
Portland, OR 97215-1693

Phone

(503) 389-0030

NPI assigned

Apr 22, 2021

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

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Desert Rose Counseling, LLC

  • Professional Counselor
  • Portland, OR
  • NPI 1336024496

  Mental Health

  NPD Authorized official

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

{
    "created_epoch": "1619049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780444800000",
    "number": "1821670670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4531 SE BELMONT ST STE 317",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972151693",
            "telephone_number": "503-389-0030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4531 SE BELMONT ST STE 317",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972151693",
            "telephone_number": "503-389-0030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1962 NW Kearney St Ste 302",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972091464",
            "country_code": "US",
            "telephone_number": "503-389-0030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "ABIGAIL",
        "middle_name": "ROSE LEI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-22",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C10900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI 2",
            "identifier": "1336024496",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "C10900",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500792702",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500873529",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ethan Bulisco
• Sarah Nicole Bulkley, EFDA
• Natalie Buller
• Rebecca Bulleri
• Samuel William Bullick, D.O.
• Baylee Bullock
• David Christopher Bullock, CRNA
• Demetria Bullock
• Gina M Bullock, DPM
• Greta Lauren Bullock, PT, DPT

• Professional Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Professional Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.