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

Jefferson Lee Bullard, LCSW

Individual provider Clinical Social Worker · NPI 1760908586

Jefferson Lee Bullard, LCSW is a Clinical Social Worker in Philadelphia, Pennsylvania. Licensed in Pennsylvania. Registered with an NPI since 2017.

Licensed in
PA
In the registry since
2017
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

3401 Civic Center Blvd
Philadelphia, PA 19104-4319
Phone: (267) 738-6526
Fax: (215) 563-0748
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence CW019448 (PA)

Record details

NPI number1760908586
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW
Sole proprietorNo
NPI enumeratedAugust 15, 2017
Last updated in NPPESMarch 4, 2026
Certification dateMarch 4, 2026

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