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NPI Code Detail

MEDICARE: JESSICA BULLOCK LCSW

MEDICARE:   JESSICA  BULLOCK  LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerCSW09931100CO

General Provider Information

NPI Number : 1134052970
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA BULLOCK LCSW
Provider Business Mailing Address
First Line : 515 S CLARKSON ST APT 908
Second Line :
City : DENVER
State : CO
Zip : 80209-4319
Country : US
Telephone Number : 630-373-9817
Fax Number :
Provider Business Practice Location Address
First Line : 777 BANNOCK ST
Second Line :
City : DENVER
State : CO
Zip : 80204-4597
Country : US
Telephone Number : 303-436-6000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2026
Last Update Date : 06/03/2026

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Directions to “ JESSICA BULLOCK LCSW” Practice Location

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