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MISS BERTHA DELOIS BULLOCK LCSWA
NPI 1174479588
Counselor - Mental Health in Raleigh, NC

Active since March 09, 2026
2472 TONOLOWAY DR, RALEIGH, NC 27610(252) 739-6641(252) 739-6641 Get Directions Write a Review

NPPES record last updated: March 9, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Miss Bertha Delois Bullock Lcswa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MISS BERTHA DELOIS BULLOCK LCSWA (NPI 1174479588) is an individual mental health provider in Raleigh, North Carolina, licensed in North Carolina (P023264) and active in the NPI registry since March 2026.

NPPES Registry Identity

NPI1174479588
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameMISS BERTHA DELOIS BULLOCKCredential: LCSWA
Location Address2472 TONOLOWAY DRRaleigh, NC 27610-7190
Mailing Address2472 Tonoloway DrRaleigh, NC 27610-7190 · (919) 790-7775 · Fax (919) 790-9755
Phone(252) 739-6641
Fax(252) 739-6641
Sole ProprietorYes
Enumeration DateMarch 9, 2026
NPPES CertifiedMarch 8, 2026
✔ NPI 1174479588 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in NC · P023264
2472 TONOLOWAY DR, Raleigh, NC 27610
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bertha Bullock's NPI number?

The NPI number for Bertha Bullock is 1174479588. It was assigned to this individual provider in the NPPES registry on March 9, 2026.

Where is Bertha Bullock located?

Bertha Bullock practices at 2472 Tonoloway Dr, Raleigh, NC 27610. The listed phone number is (252) 739-6641.

What is Bertha Bullock's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Bertha Bullock was last updated on March 9, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.