Individual provider · Type 1 NPI

Micah J. Bulloch, LCSW

Clinical Social Worker · Cedar City, UT

NPI number 1679082952 Active

Practice location

245 E 680 S
Cedar City, UT 84720-3593

Call (435) 867-7654 Map

Fax (435) 867-7699

Mailing address

2505 Idlewilde Dr
Midland, TX 79707-6120

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker 1041C0700X107800 (TX)
Case Manager/Care Coordinator 171M00000XNone listed
Clinical Social Worker 1041C0700X8371889 (ID)
Clinical Social Worker Primary 1041C0700X8765778-3501 (UT)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1679082952

Micah J. Bulloch, LCSW's National Provider Identifier is 1679082952, issued on Sep 29, 2017. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Cedar City, UT. The record was last updated on Apr 7, 2026.