Matt Kevin Bulloch, L.P.C. NCC
Counselor, Professional in Cedar City, UT. Individual provider (NPI-1).
NPI number1457526337
StatusActive
Last updated in NPPESNov 11, 2009
Details
- NPI
- 1457526337
- Entity type
- Individual (NPI-1)
- Name
- Mr. Matt Kevin Bulloch
- Credential
- L.P.C. NCC
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Apr 23, 2008
- Last updated
- Nov 11, 2009
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | 2785863-6004 | UT | Yes |
| 101YM0800X | Counselor, Mental Health | 2785863-6004 | UT |
Practice location
2460 W Highway 56#5
Cedar City, UT 84720-4118
Phone 435-327-2137
Mailing address
1009 Ironwood CirCedar City, UT 84721-5125
Phone 435-327-2137
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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