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

Mary Alisa Bullock, LPCA, LCASA, NCC

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1902458037

Mary Alisa Bullock, LPCA, LCASA, NCC is a Mental Health Counselor in Lexington, North Carolina. Qualified in 2019, 7 years ago. Practices with Daymark Recovery Services Inc, a 129-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
7
Licensed in
NC
In the registry since
2019
Specialties on file
4
What do these letters mean?
NCC — National Certified Counselor
A counsellor certified by the NBCC.

See every abbreviation used in this directory →

Practice location Address checks out

1104A S Main St
Lexington, NC 27292-3134
Phone: (336) 242-2450
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 806 Bell Fork Rd, Jacksonville, NC 28540-6312 — (910) 347-2205

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence LCAS-25659 (NC)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence 25659 (NC)
Mental Health Counselor Taxonomy 101YM0800X · Licence A14910 (NC)
Professional Counselor Taxonomy 101YP2500X · Licence 14910 (NC)

Record details

NPI number1902458037
Entity typeIndividual (Type 1)
GenderFemale
Credentials LPCA , LCASA , NCC
Sole proprietorNo
NPI enumeratedJuly 9, 2019
Last updated in NPPESDecember 1, 2022
Certification dateDecember 1, 2022

Medicare enrollment

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

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Daymark Recovery Services Inc — 129 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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