Krista M McCulloch, LSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

S.0800738 Issued in OH

Practice address

1627 Henthorne Dr Ste C
Maumee, OH 43537-1370

Phone

(419) 491-0420

NPI assigned

Sep 11, 2013

Last updated

Mar 13, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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 1

Specialty

Clinical Social Worker

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Anchored in Hope Counseling, LLCGroup PAC ID 5294166138, 6 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Anchored in Hope Counseling, LLC

  • Clinical Social Worker
  • Maumee, OH
  • NPI 1437626587
  Medicare reassignment Care Compare group NPD Authorized official
• Anchored in Hope Counseling, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Maumee, OH
  • NPI 1033845276
  NPD Authorized official
• Beech Brook

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Cleveland, OH
  • NPI 1437399474
  NPD (past)

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

{
    "created_epoch": "1378857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584057600000",
    "number": "1124453907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 823",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435520823",
            "telephone_number": "419-491-0420",
            "fax_number": "567-698-7875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1627 HENTHORNE DR STE C",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435371370",
            "telephone_number": "419-491-0420"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11801 Buckeye Rd",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441202620",
            "country_code": "US",
            "telephone_number": "216-831-2255",
            "fax_number": "216-378-3906",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCULLOCH",
        "first_name": "KRISTA",
        "middle_name": "M",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-11",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S.0800738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley McClain, RBT
• Angela McClellan, LPCC
• Kurt David McClurg, ATC
• Ashlee McCoy, CDCA
• Michael Andrew McCray, LISW
• Mila Shavel McFall, STNA
• Ryan McFann
• Nyia McFarland-Clemons, RN
• Mary McGill
• Stephanie Lee McGill, M.A. CCC-SLP

• Clinical Social Worker in Maumee, OH
• Providers in Maumee, 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 Mar 13, 2020; 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.