P Praxis·MD
● Active Type 1 · Individual

DR. Mark Dana Bullock, PH.D.

Counselor·Hayden, ID· NPI 1346370277 · Enumerated 2007 · 19 years on NPI
Bullock is 1 of 14 counselor providers in Hayden and 1 of 1998 in Idaho.
NPI age
19 years
Enumerated 2007-03-07
Primary specialty
Counselor
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2007-07-08
Source: monthly bulk 2026-05
Sole proprietor
Yes
Solo practice on file

How this provider compares

Across 1998 active counselor providers in Idaho.

NPI age
19 years
↑ 12 yr above median (7 yr)
State licenses
1 state
4% of peers hold multiple states
Subspecialties
0
21% of peers hold subspecialties

NPI lifetime · 2007 → 2026

2007-03Enumerated in NPPES
2007 2026

Where they practice

Practice location
6160 E Hayden Lake Rd
Hayden, ID 838357594
📞 2086998044
Mailing address
6160 E Hayden Lake Rd
Hayden, ID 838357594
📞 2086998044

Specialties

  • Counselor Primary
    Definition to come...
    ID license #LPC-988 taxonomy 101YM0800X

Practice context

Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.

Recently enumerated nearby: 1 new counselor provider has been added in Hayden in the last 180 days. See all →
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How to verify this provider

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Check the state license is currently active.State licensing boards publish current status; NPPES does not.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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