Healthcare Provider Details

I. General information

NPI: 1982136537
Provider Name (Legal Business Name): WILLIAM B BULLER JR. LCSW, LADC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2017
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1007 N MAIN ST
DAYVILLE CT
06241-2170
US

IV. Provider business mailing address

677 S MAIN ST STE 5A
CHESHIRE CT
06410-3161
US

V. Phone/Fax

Practice location:
  • Phone: 607-774-2020
  • Fax: 860-774-0826
Mailing address:
  • Phone: 860-506-6016
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number1463
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number16274
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: