Provider Demographics
NPI:1821194234
Name:BULLION, REBECCA VARNUM (LCSW)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:VARNUM
Last Name:BULLION
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 HAZEL PATH
Mailing Address - Street 2:SUITE 4
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-3888
Mailing Address - Country:US
Mailing Address - Phone:615-822-7889
Mailing Address - Fax:615-822-7801
Practice Address - Street 1:109 HAZEL PATH
Practice Address - Street 2:SUITE 4
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-3888
Practice Address - Country:US
Practice Address - Phone:615-822-7889
Practice Address - Fax:615-822-7801
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4035128103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4114563OtherBCBS