Michael Craig Bullock, MSW, LCSW
Social Worker, Clinical in Augusta, GA. Individual provider (NPI-1).
NPI number1609005446
StatusActive
Last updated in NPPESJan 5, 2016
Details
- NPI
- 1609005446
- Entity type
- Individual (NPI-1)
- Name
- Michael Craig Bullock
- Credential
- MSW, LCSW
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 14, 2009
- Last updated
- Jan 5, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | CSW005575 | GA | Yes |
| 1041C0700X | Social Worker, Clinical | 11196 | SC |
Practice location
950 15th StAugusta, GA 30901-2608
Phone 706-733-0188
Mailing address
950 15th StAugusta, GA 30901-2608
Phone 706-733-0188
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