Monica Bullock, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

80129 Issued in TX

Practice address

701 E Marshall Ave Ste 310
Longview, TX 75601-5544

Phone

(903) 234-9200

NPI assigned

Feb 10, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

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.

• Sabine Valley Regional MHMR Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Longview, TX
  • NPI 1639232002

  Professional

  Medicare reassignment NPD
• Sabine Valley Regional MHMR Center

  • Family Medicine Physician
  • Longview, TX
  • NPI 1841835022
  NPD

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

{
    "created_epoch": "1581292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682899200000",
    "number": "1972135655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 E MARSHALL AVE STE 310",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756015544",
            "telephone_number": "903-234-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E MARSHALL AVE STE 310",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756015544",
            "telephone_number": "903-234-9200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "559 N Marlborough Cir",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711066132",
            "country_code": "US",
            "telephone_number": "903-932-1998",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "MONICA",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-10",
        "last_updated": "2023-05-01",
        "certification_date": "2023-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "LA",
            "license": "9306",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "80129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Buckner Children and Family Services
• Buckner Retirement Services, Inc
• Buckner Retirement Services, Inc.
• Jaylie Brooke Buckner, NP
• Nancy Buettner, PA-C
• Yolanda Patricia Bunce, R.PH.
• Darrell A Bunch, D.O.
• Megan Burch, LPC
• Paul L. Burch, PA-C
• James David Burgan

• Professional Counselor in Longview, TX
• Providers in Longview, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.