Individual
SAMUEL BULLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2277 SUNSET BLVD, WEST COLUMBIA, SC 29169-4713
(888) 796-1117
(803) 996-5228
Mailing address
2277 SUNSET BLVD, WEST COLUMBIA, SC 29169-4713
(888) 796-1117
(803) 996-5228
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
Primary
10394
SC
Other
Enumeration date
06/05/2024
Last updated
06/03/2026
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