Individual provider · Type 1 NPI

Mary Alisa Bullock, LPCA, LCASA, NCC

Addiction (Substance Use Disorder) Counselor · Lexington, NC

NPI number 1902458037 Active

Practice location

1104A S Main St
Lexington, NC 27292-3134

Call (336) 242-2450 Map

Mailing address

284 Executive Park Dr Ste 100
Concord, NC 28025-1833

Other practice locations

  • 806 Bell Fork Rd, Jacksonville, NC 28540-6312 · (910) 347-2205

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor 101YA0400X25659 (NC)
Mental Health Counselor 101YM0800XA14910 (NC)
Professional Counselor 101YP2500X14910 (NC)
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XLCAS-25659 (NC)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1902458037

Mary Alisa Bullock, LPCA, LCASA, NCC's National Provider Identifier is 1902458037, issued on Jul 9, 2019. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Lexington, NC. The record was last updated on Dec 1, 2022.