Individual
DR. LEWIS A BULLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NCC
Contact information
Practice address
15 PROFESSIONAL PKWY STE 100, HATTIESBURG, MS 39402-2647
(601) 768-7272
(601) 768-2429
Mailing address
PO BOX 15324, HATTIESBURG, MS 39404-5324
(601) 768-7272
(601) 448-6947
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
225797
MS
101YP2500X
Professional Counselor
Primary
225797
MS
Other
Enumeration date
08/13/2009
Last updated
03/18/2026
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