Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dominique Bullock

Individual provider Clinical Social Worker · NPI 1396698726

Dominique Bullock is a Clinical Social Worker in Miami, Florida. Qualified in 2021, 5 years ago. Practices as a sole proprietor and works from 2 locations. Licensed in Florida.

Years since qualifying
5
Licensed in
FL
In the registry since
2026

Practice location Address checks out

22790 SW 112th Ave
Miami, FL 33170-7602
Phone: (305) 609-1470
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 23419 Sw 127th Pl, Homestead, FL 33032-9215 — (305) 609-1470

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence SW25515 (FL)

Record details

NPI number1396698726
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedFebruary 16, 2026
Last updated in NPPESMay 27, 2026
Certification dateMay 27, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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