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General NPI Number Information
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NPI Number | 1265004378
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Entity Type | Individual
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Provider Name | EMILY JEAN BULLARD LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/16/2021
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Last Update Date | 08/12/2025
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Provider Practice Location Address
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Address Line | 6550 W EMERALD ST STE 112
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City | BOISE
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State | ID
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Zip | 83704-8780
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Country | US
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Telephone | 208-342-6300
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Fax | 208-342-6301
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Provider Business Mailing Address
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Address Line | 1917 ABBOTT RD STE 101
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City | ANCHORAGE
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State | AK
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Zip | 99507-3449
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Country | US
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Telephone | 877-840-6956
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Fax | 619-383-6701
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 231795
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License Number State | AK
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 41032
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License Number State | ID
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 18341
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License Number State | FL
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