Amy Bullock, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

61927 Issued in CA

Practice address

1073 Ross Ave Ste C
El Centro, CA 92243-4371

Phone

(760) 540-4335

Fax

(760) 482-5696

NPI assigned

Oct 22, 2014

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

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Clinical Social Worker

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Carative Psychiatry Nursing CorporationGroup PAC ID 8628510310, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Carative Psychiatry Nursing Corporation

  • Psychiatric/Mental Health Nurse Practitioner
  • San Francisco, CA
  • NPI 1194478735
  Medicare reassignment Care Compare group NPD
• Imperial Manor Skilled Nursing Inc

  • Rural Health Clinic/Center
  • Brawley, CA
  • NPI 1912662883
  Medicare reassignment NPD
• Legacy MD Medical Group Inc

  • General Practice Physician
  • El Centro, CA
  • NPI 1073210753
  Medicare reassignment NPD
• Easyaccess Medical Group, Inc

  • Urgent Care Clinic/Center
  • Calexico, CA
  • NPI 1386160810
  NPD (past)
• Gabriel Lam, Licensed Clinical Social Worker, Inc.

  • Community/Behavioral Health Agency
  • El Centro, CA
  • NPI 1487173522
  NPD (past)
• Carative Psychiatry PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • St Petersburg, FL
  • NPI 1437745874
  NPD (past)

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

{
    "created_epoch": "1413936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413936000000",
    "number": "1871997692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 W PHEASANT ST",
            "city": "HEBER",
            "state": "CA",
            "postal_code": "922499658",
            "telephone_number": "760-540-4335",
            "fax_number": "760-482-5696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1073 ROSS AVE STE C",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922434371",
            "telephone_number": "760-540-4335",
            "fax_number": "760-482-5696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "AMY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-22",
        "last_updated": "2014-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "61927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lucille Romero Britton
• Amanda C Broedell
• Lola Burnett Brown, MD
• Luis Brown
• Trang Thai Brown
• Herbert Ray Bumgart Jr.
• Janet Lavon Burgess, RDHAP, BS
• Alejandra Burgos Dominguez
• Adli Dennise Burgos
• Brooke Burns, D.O.

• Clinical Social Worker in El Centro, CA
• Providers in El Centro, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.