Aimee E McCullough, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

04720 Issued in MD

Practice address

9881 Brokenland Pkwy
105
Columbia, MD 21046-1172

Phone

(808) 372-7002

Fax

(808) 372-7002

NPI assigned

Oct 24, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Networks

• devoted network organization-c89d4c14-e90f-4cf7-83f9-456527a52335
• HI PPO

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347408000000",
    "number": "1003990607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3525 SPLIT RAIL LN",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210423832",
            "telephone_number": "808-372-7002",
            "fax_number": "808-372-7002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9881 BROKENLAND PKWY",
            "address_2": "105",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210461172",
            "telephone_number": "808-372-7002",
            "fax_number": "808-372-7002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOUGH",
        "first_name": "AIMEE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2012-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "HI",
            "license": "PSY461",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "04720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07140002",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA",
            "identifier": "0000092858",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Drew-Taylor McCrae
• Lea McCray
• Tia McCray, NP
• Amy Lee McCready, RN
• Jasmine McCree
• Nwakanma McCullough
• Gillian Leigh McCusker
• Cassandra B McDaniel, M.D.
• Alyssa McDermott
• Cherise Maria McDonald

• Clinical Psychologist in Columbia, MD
• Providers in Columbia, MD by specialty
• Clinical Psychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.