Active NPI
Shaun Bully
- Clinical Social Worker
- Washington, DC
National Provider Identifier
1922775014
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LC50081064
- Practice address
- 1500 Franklin St NE
Washington, DC 20018-2000 - Phone
- (202) 745-3012
- NPI assigned
- Aug 25, 2021
- Sex
- Male
- Sole proprietor
- Yes
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 | LC50081064 | DC | Primary |
Addresses
Primary practice location
1500 Franklin St NE
Washington, DC 20018-2000
Mailing address
4322 3Rd St NW
Washington, DC 20011-7316
Phone (786) 239-7779
Other practice location 1
50 Irving St NW
Washington, DC 20422-0001
Phone (202) 745-8000
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 |
|---|---|---|---|
| LC50081064 | DC | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629849600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629849600000",
"number": "1922775014",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4322 3RD ST NW",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200117316",
"telephone_number": "786-239-7779"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 FRANKLIN ST NE",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200182000",
"telephone_number": "202-745-3012"
}
],
"practiceLocations": [
{
"address_1": "50 Irving St NW",
"address_purpose": "LOCATION",
"city": "Washington",
"state": "DC",
"postal_code": "204220001",
"country_code": "US",
"telephone_number": "202-745-8000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BULLY",
"first_name": "SHAUN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-08-25",
"last_updated": "2021-08-25",
"certification_date": "2021-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "DC",
"license": "LC50081064",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.