Individual provider Active NPI

Evelyn Louise Bull

  • Addiction (Substance Use Disorder) Counselor
  • Greenville, SC
National Provider Identifier
1962165183
Registry record updated Oct 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
570542729 Issued in SC
Practice address
1400 Cleveland St
Greenville, SC 29607-2410
Phone
(864) 467-3790
NPI assigned
Oct 14, 2021
Last updated
Oct 14, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 570542729 SC Primary

Addresses

Primary practice location

1400 Cleveland St
Greenville, SC 29607-2410

Mailing address

563 Lowndes Hill Rd
Greenville, SC 29607-1471
Phone (843) 816-7040

Other identifiers 1

IdentifierTypeStateIssuer
570542729MedicaidSC

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

LicenseStateTypeSpecialty
570542729SCMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1634169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634169600000",
    "number": "1962165183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "563 LOWNDES HILL RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296071471",
            "telephone_number": "843-816-7040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 CLEVELAND ST",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296072410",
            "telephone_number": "864-467-3790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULL",
        "first_name": "EVELYN",
        "middle_name": "LOUISE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-14",
        "last_updated": "2021-10-14",
        "certification_date": "2021-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "SC",
            "license": "570542729",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "570542729",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.

Verify at the official NPI Registry.