Individual provider Active NPI

Angela Brown Bulla, LCSW

  • Clinical Social Worker
  • Clearwater, FL
National Provider Identifier
1841323482
Registry record updated Feb 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW10862 Issued in FL
Practice address
51 S Main Ave Ste 304
Clearwater, FL 33765-3937
Phone
(727) 328-4672
NPI assigned
Mar 13, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW10862 FL Primary

Addresses

Primary practice location

51 S Main Ave Ste 304
Clearwater, FL 33765-3937

Mailing address

51 S Main Ave Ste 304
Clearwater, FL 33765-3937
Phone (727) 328-4672

Other identifiers 1

IdentifierTypeStateIssuer
004130800MedicaidFL

Other names 1

  • Angela Brown Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20130613000462 FL Practitioner - Clinical Social Worker 4284873712 Practice locations: Clearwater, FL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2270 Drew St C
Clearwater, FL 33765-3344
Phone (727) 784-8244

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Angela Brown Bulla LCSW Clinical CurrentSince Jul 1, 2011 Accepting new patients

Locations

2270 Drew St
Ste C
Clearwater, FL 33765
Phone (727) 328-4672

51 S Main Ave
Ste 304
Clearwater, FL 33765
Phone (727) 784-8244

Networks

  • Freedom Health HMO Network

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643846400000",
    "number": "1841323482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 S MAIN AVE STE 304",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337653937",
            "telephone_number": "727-328-4672",
            "fax_number": "727-287-9302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 S MAIN AVE STE 304",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337653937",
            "telephone_number": "727-328-4672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN BULLA",
        "first_name": "ANGELA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-13",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW10862",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004130800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "BROWN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.