| Susan H. Bullard, Lisw-cp, Llc | |
|
1624 Ebenezer Rd Rock Hill SC 29732-1809 | |
| (803) 599-8869 | |
| Not Available |
| Full Name | Susan H. Bullard, Lisw-cp, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1624 Ebenezer Rd, Rock Hill, South Carolina |
| Authorized Official Name and Position | Susan H Bullard (CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 8035998869 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Susan H. Bullard, Lisw-cp, Llc Po Box 746 Fort Mill SC 29716-0746 Ph: (803) 599-8869 | Susan H. Bullard, Lisw-cp, Llc 1624 Ebenezer Rd Rock Hill SC 29732-1809 Ph: (803) 599-8869 |
| NPI Number | 1760923551 |
|---|---|
| Provider Enumeration Date | 03/14/2017 |
| Last Update Date | 04/28/2017 |
| Medicare PECOS PAC ID | 9335417526 |
|---|---|
| Medicare Enrollment ID | O20170612001583 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760923551 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 8752 (South Carolina) | Primary |
| Provider Name | Susan H Bullard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417131814 PECOS PAC ID: 5395823272 Enrollment ID: I20080814000089 |
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