Provider Demographics
NPI:1558569863
Name:BULKLEY, JOSEPHINE (MSW,JD)
Entity Type:Individual
Prefix:MS
First Name:JOSEPHINE
Middle Name:
Last Name:BULKLEY
Suffix:
Gender:F
Credentials:MSW,JD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5028 WISCONSIN AVE NW
Mailing Address - Street 2:SUITE 303
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-4118
Mailing Address - Country:US
Mailing Address - Phone:202-422-3553
Mailing Address - Fax:301-320-5860
Practice Address - Street 1:5028 WISCONSIN AVE NW
Practice Address - Street 2:SUITE 303
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-4118
Practice Address - Country:US
Practice Address - Phone:202-422-3553
Practice Address - Fax:301-320-5860
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC3035851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical