Louise Gottlob Cullen, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LISW-19236 Issued in AZ

Practice address

35000 Chardon Rd #210
Diane Eden MD and Assoc.
Willoughby Hills, OH 44094

Phone

(440) 951-5600

Fax

(440) 951-1293

NPI assigned

Apr 3, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Louise J Cullen Former name

Medicare fee-for-service enrollment

Enrolled in OH, AZ2 enrollments

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 2

Specialty

Clinical Social Worker

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Pacific Coast Psychiatric Associates IncGroup PAC ID 2567469174, 637 clinicians

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.

• Pacific Coast Psychiatric Associates Inc

  • Clinical Psychologist
  • Scottsdale, AZ
  • NPI 1023125465
  Medicare reassignment Care Compare group NPD
• Psychological & Behavioral Consultants, LLC

  • Psychiatry Physician
  • Beachwood, OH
  • NPI 1811915713

  Clinical

  Medicare reassignment NPD
• Psychology Specialists LTD

  • Clinical Psychologist
  • Las Vegas, NV
  • NPI 1003473448
  NPD (past)

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717718400000",
    "number": "1104888569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35000 CHARDON RD #210",
            "address_2": "DIANE EDEN MD AND ASSOC.",
            "city": "WILLOUGHBY HILLS",
            "state": "OH",
            "postal_code": "44094",
            "telephone_number": "440-951-5600",
            "fax_number": "440-951-1293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35000 CHARDON RD #210",
            "address_2": "DIANE EDEN MD AND ASSOC.",
            "city": "WILLOUGHBY HILLS",
            "state": "OH",
            "postal_code": "44094",
            "telephone_number": "440-951-5600",
            "fax_number": "440-951-1293"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7373 N Scottsdale Rd Ste A199",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852533593",
            "country_code": "US",
            "telephone_number": "702-805-5360",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOTTLOB CULLEN",
        "first_name": "LOUISE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-03",
        "last_updated": "2024-06-07",
        "certification_date": "2024-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "7128",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LISW-19236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LOUISE",
            "last_name": "CULLEN",
            "middle_name": "J",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• William Golnick, PHARMD
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• Great Quality Home Care LLC
• Rosa Green

• Clinical Social Worker in Willoughby Hills, OH
• Providers in Willoughby Hills, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2024; 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.