Jamie Lynn Cullen, LMHC, IADC, CCMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

072527 Issued in IA

Practice address

3475 Jersey Ridge Rd
Davenport, IA 52807-2293

Phone

(563) 349-5235

NPI assigned

Jun 19, 2017

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2011

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Banyan Tree Counseling PLLC

  • Counselor
  • Winston Salem, NC
  • NPI 1720619968

  Mental Health

  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1497830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497830400000",
    "number": "1003346370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3865 TANGLEFOOT CT",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527222152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3475 JERSEY RIDGE RD",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528072293",
            "telephone_number": "563-349-5235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CULLEN",
        "first_name": "JAMIE",
        "middle_name": "LYNN",
        "credential": "LMHC, IADC, CCMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-19",
        "last_updated": "2017-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "072527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Ambrose Cronkleton, M.D.
• Kara Kathleen Crosby, D.O.
• Megan Crosmer, M.D.
• Linda Marie Crownover-Inch, DOULA
• Tengyi Cui, RPH
• Sydney Marie Cummings, OTD
• Arwyn Grace Cunningham, D.O.
• Curo Health Services, LLC
• Michael Evan Currie, DC
• Brianna Curtin

• Mental Health Counselor in Davenport, IA
• Providers in Davenport, IA by specialty
• Mental Health Counselor in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.