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

Mr. Charles Martin Bullard, LICSW

Individual provider Psychoanalyst · NPI 1174736334

Mr. Charles Martin Bullard, LICSW is a Psychoanalyst in Seattle, Washington. Licensed in Washington. Registered with an NPI since 2007.

Licensed in
WA
In the registry since
2007
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

2206 Queen Anne Ave N #203
Seattle, WA 98109-2370
Phone: (206) 283-4360
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychoanalyst (primary) Taxonomy 102L00000X · Licence 020704-LW00006183 (WA)

Record details

NPI number1174736334
Entity typeIndividual (Type 1)
GenderMale
Credentials LICSW
Sole proprietorNo
NPI enumeratedMay 7, 2007
Last updated in NPPESJuly 8, 2007

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