Individual provider · Type 1 NPI

Phoenix Bullis-Caballos

Clinical Social Worker · Brandon, FL

NPI number 1871302919 Active

Practice location

1106 Nikki View Dr
Brandon, FL 33511-4868

Mailing address

10914 Le Jardin Cir Apt 102
Temple Terrace, FL 33617-2810

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700XSW26301 (FL)

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 1871302919

Phoenix Bullis-Caballos's National Provider Identifier is 1871302919, issued on Jan 3, 2025. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Brandon, FL. The record was last updated on May 6, 2026.