NPIMap

Organization Active NPI

Brad Cullum Counseling PLLC

Doing business as Harvest Counseling and Wellness

  • Clinical Social Worker
  • Lantana, TX
National Provider Identifier
1104438795
Registry record updated Aug 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
BRAD CULLUM COUNSELING PLLC
Doing business as
Harvest Counseling and Wellness
Practice address
142 Old Town Blvd N Ste 200
Lantana, TX 76226-3954
Phone
(940) 294-7061
NPI assigned
Aug 17, 2020
Last updated
Aug 17, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2020

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

Authorized official

Name
Brad Cullum
Title
President
Phone
(940) 294-7061

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101Y00000X
Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 104100000X
Clinical Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

142 Old Town Blvd N Ste 200
Lantana, TX 76226-3954

Mailing address

142 Old Town Blvd N Ste 200
Lantana, TX 76226-3954
Phone (940) 294-7061

Other names 1

  • Harvest Counseling and Wellness Doing business as

National Provider Directory

National Provider Directory

Locations

142 Old Town Blvd N
Ste 200
Lantana, TX 76226
Phone (940) 204-8935

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1597622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597622400000",
    "number": "1104438795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 OLD TOWN BLVD N STE 200",
            "city": "LANTANA",
            "state": "TX",
            "postal_code": "762263954",
            "telephone_number": "940-294-7061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 OLD TOWN BLVD N STE 200",
            "city": "LANTANA",
            "state": "TX",
            "postal_code": "762263954",
            "telephone_number": "940-294-7061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAD CULLUM COUNSELING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-17",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A",
        "authorized_official_last_name": "CULLUM",
        "authorized_official_first_name": "BRAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "940-294-7061"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Harvest Counseling and Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lantana, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2020; 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.