Ryan Bullard, Lcsw - Medicare Mental Health Clinic in Crestview, FL

Ryan Bullard, Lcsw is a medicare enrolled mental health clinic (Counselor - Mental Health) in Crestview, Florida. The current practice location for Ryan Bullard, Lcsw is 128 John King Rd Ste 18, Crestview, Florida. For appointments, you can reach them via phone at (850) 347-5457. The mailing address for Ryan Bullard, Lcsw is 128 John King Rd Ste 18, Crestview, Florida and phone number is (850) 347-5457.

Ryan Bullard, Lcsw is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1235707472. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (850) 347-5457.

Contact Information

Ryan Bullard, Lcsw
128 John King Rd Ste 18
Crestview
FL 32539-5731
(850) 347-5457
(850) 779-3117

Mental Health Clinic Profile

Full NameRyan Bullard, Lcsw
SpecialityCounselor
Location128 John King Rd Ste 18, Crestview, Florida
Authorized Official Name and PositionRyan Bullard (CEO)
Authorized Official Contact8503475457
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Ryan Bullard, Lcsw
128 John King Rd Ste 18
Crestview
FL 32539-5731

Ph: (850) 347-5457
Ryan Bullard, Lcsw
128 John King Rd Ste 18
Crestview
FL 32539-5731

Ph: (850) 347-5457

NPI Details:

NPI Number1235707472
Provider Enumeration Date06/14/2021
Last Update Date03/31/2023
Certification Date03/31/2023

Medicare PECOS Information:

Medicare PECOS PAC ID0244603660
Medicare Enrollment IDO20230307000016

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Medical Identifiers

Medical identifiers for Ryan Bullard, Lcsw such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1235707472NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
101Y00000XCounselor (* (Not Available))Secondary
101YM0800XCounselor - Mental Health (* (Not Available))Primary
1041C0700XSocial Worker - Clinical (* (Not Available))Secondary
261QM0801XClinic/center - Mental Health (including Community Mental Health Center) (* (Not Available))Secondary
261QR0405XClinic/center - Rehabilitation, Substance Use Disorder (* (Not Available))Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Ryan Bullard, Lcsw acts as a billing entity for following providers:
Provider NameRyan Bullard
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1265072326
PECOS PAC ID: 1153794573
Enrollment ID: I20230307000040

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Counselor in Crestview, FL

Bridgeway Center, Inc
Mental Health Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 2007 W James Lee Blvd, Crestview, FL 32536
Phone: 850-689-7827    Fax: 850-689-7828
Ascent Christian Counseling, Llc
Mental Health Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 824 N Ferdon Blvd, Crestview, FL 32536
Phone: 850-603-0941    
Star Behavior Consulting, Llc
Mental Health Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 301 E Hickory Ave, Crestview, FL 32536
Phone: 850-329-8641    
Ppcc, Inc.
Mental Health Clinic
Medicare: Medicare Enrolled
Practice Location: 259 E Oakdale Ave, Crestview, FL 32539
Phone: 850-398-5255    Fax: 850-689-8799
Solaris Counseling Services, Llc
Mental Health Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 721 Ashley Dr, Crestview, FL 32536
Phone: 352-478-4005    Fax: 352-478-4006
Crestview Neurology
Mental Health Clinic
Medicare: Medicare Enrolled
Practice Location: 535 S Ferdon Blvd, Suite C, Crestview, FL 32536
Phone: 850-423-4664    Fax: 850-398-8824

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