Irene Ervin Bullock, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904014900 Issued in VA

Practice address

1600 Westbrook Ave Ste 134
Richmond, VA 23227-3326

Phone

(804) 292-3500

Fax

(888) 382-0230

NPI assigned

Jul 7, 2023

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 names 1

• Irene Elizabeth Ervin Former name

Medicare fee-for-service enrollment

Enrolled in VA

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, 1996

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Mental Health Specialty Group PA

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  Multi-Specialty, VA

  Medicare reassignment NPD

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

{
    "created_epoch": "1688688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1922786268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7331 RIVENDELL TER",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232345970",
            "telephone_number": "804-497-9518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 WESTBROOK AVE STE 134",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232273326",
            "telephone_number": "804-292-3500",
            "fax_number": "888-382-0230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "IRENE",
        "middle_name": "ERVIN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-07",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904014900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IRENE",
            "last_name": "ERVIN",
            "middle_name": "ELIZABETH",
            "credential": "MSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mariana Kendall Bulich
• Adam William Bullock, M.D.
• Ashley Bullock
• Candice Bullock, LMSW, LCSW
• Enoch Hananiah Bullock, M.ED.
• Janet Bullock, CPT
• John Paul Bullock Jr., M.D.
• Mary D. Bullock, OTRL
• Peter R Bumanis, D.O.
• Amanda Lynnette Bumgarner, ACCNS-P

• Clinical Social Worker in Richmond, VA
• Providers in Richmond, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2024; 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.