Anita Eileen McCulloch, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

3141 Issued in KY

Practice address

2105 Crums LN
Suite 8
Louisville, KY 40216-4231

Phone

(502) 693-5870

NPI assigned

Jan 11, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458000000000",
    "number": "1083764922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W MUHAMMAD ALI BLVD",
            "address_2": "SUITE 8",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021423",
            "telephone_number": "502-586-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 CRUMS LN",
            "address_2": "SUITE 8",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402164231",
            "telephone_number": "502-693-5870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOCH",
        "first_name": "ANITA",
        "middle_name": "EILEEN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2016-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "3141",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30615058",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erica McCubbins
• Faith McCubbins, RBT
• Sarah Elizabeth McCubbins, PHARMD
• Lisa Michelle McCue, BS
• Benjamin R McCullar, DPM
• Kelly McCulloch
• Gregory Ross McCullough, PT, DPT
• Pamela Ann McCullough, APRN
• Tiffany Lynn McCullough
• Valerie McCullough

• Clinical Social Worker in Louisville, KY
• Providers in Louisville, KY by specialty
• Clinical Social Worker in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2016; 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.