NPIMap

Organization Active NPI

McCullough Counseling & Recovery LLC

  • Community/Behavioral Health Agency
  • Omaha, NE
National Provider Identifier
1134450935
Registry record updated Jan 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
3302 Issued in NE
Legal business name
MCCULLOUGH COUNSELING & RECOVERY LLC
Practice address
5951 Ames Ave
# 28
Omaha, NE 68104-2705
Phone
(402) 457-5761
Fax
(402) 457-1997
NPI assigned
Jan 19, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2010

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

Authorized official

Name
Mrs. Cynthia R McCullough, MHR, LMHP, LADC
Title
Ceo
Phone
(402) 457-5761

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 3302 NE Primary
Community/Behavioral Health Agency 251S00000X 603 NE

Addresses

Primary practice location

5951 Ames Ave
# 28
Omaha, NE 68104-2705

Mailing address

5951 Ames Ave
# 28
Omaha, NE 68104-2705
Phone (402) 457-5761

Other identifiers 1

IdentifierTypeStateIssuer
10025813200MedicaidNE

National Provider Directory

National Provider Directory
Tax ID family
McCullough Counseling Recovery LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5951 Ames Ave
#28
Omaha, NE 68104
Phone (402) 457-5761

NPI Registry JSON

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

{
    "created_epoch": "1263859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263859200000",
    "number": "1134450935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5951 AMES AVE",
            "address_2": "# 28",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681042705",
            "telephone_number": "402-457-5761",
            "fax_number": "402-457-1997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5951 AMES AVE",
            "address_2": "# 28",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681042705",
            "telephone_number": "402-457-5761",
            "fax_number": "402-457-1997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCCULLOUGH COUNSELING & RECOVERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-19",
        "last_updated": "2010-01-19",
        "status": "A",
        "authorized_official_last_name": "MCCULLOUGH",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "402-457-5761",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MHR, LMHP, LADC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NE",
            "license": "3302",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NE",
            "license": "603",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025813200",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2010; 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.