Individual
BRENT BULLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
1100 BATTLEFIELD BLVD S UNIT 15777, CHESAPEAKE, VA 23328-1231
(757) 296-0414
Mailing address
1100 BATTLEFIELD BLVD S UNIT 15777, CHESAPEAKE, VA 23328-1231
(757) 296-0414
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LH60712904
WA
101YP2500X
Professional Counselor
Primary
0701008190
VA
Other
Enumeration date
01/29/2014
Last updated
05/16/2024
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