Willie McCullough

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

261QA0600X Issued in MI

Practice address

23751 Coyle St
Oak Park, MI 48237-1929

Phone

(248) 506-5891

NPI assigned

Aug 13, 2015

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1439424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439424000000",
    "number": "1104292127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22590 PEMBROKE AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482191158",
            "telephone_number": "313-574-7976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23751 COYLE ST",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482371929",
            "telephone_number": "248-506-5891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOUGH",
        "first_name": "WILLIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-13",
        "last_updated": "2015-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401013637",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "261QA0600X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary A May
• Ken D Maynard
• Mays Property Management
• Natasha McClendon
• Lashonda McCollum, FNP-BC
• Alexis Deanna McDonald, LCMSW
• Michelle Maree McGarrity, MA LLP
• Charles Richard McLeod, D.D.S.
• Timothy Edward McPhail, LLMSW
• Meadow Oaks Home Care LLC

• Mental Health Counselor in Oak Park, MI
• Providers in Oak Park, MI by specialty
• Mental Health Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2015; 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.