Sonja P Bullock, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C4937 Issued in MS

Practice address

508 Cedarwood Dr
Jackson, MS 39212-2220

Phone

(601) 214-8157

Fax

(601) 371-0905

NPI assigned

Jul 20, 2011

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1311120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311120000000",
    "number": "1992093215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 CEDARWOOD DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392122220",
            "telephone_number": "601-214-8157",
            "fax_number": "601-371-0905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 CEDARWOOD DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392122220",
            "telephone_number": "601-214-8157",
            "fax_number": "601-371-0905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "SONJA",
        "middle_name": "P",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-20",
        "last_updated": "2011-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "C4937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bianca Bullie-Thompson, FNP-C, PMHNP-BC
• Christopher Bullin, O.D.
• Scott Bulloch
• Anna Lee Bullock
• Brittany Bullock, MS,CAT
• Dominique Bullocks
• Angelica Walinski Bulmash, DO
• Gabriel Mahasi Buluku
• Michele Bunch, LPC
• Megan Bunniran, LPC-S

• Clinical Social Worker in Jackson, MS
• Providers in Jackson, MS by specialty
• Clinical Social Worker in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2011; 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.