Tiffany Vilese McCullough, LMFTA

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

12099A Issued in NC

Practice address

5200 Park Rd Ste 218B
Charlotte, NC 28209-3650

Phone

(866) 700-1606

Fax

(866) 338-5921

NPI assigned

Jun 12, 2018

Last updated

Jun 10, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Sparc Network

  • Community/Behavioral Health Agency
  • Charlotte, NC
  • NPI 1396155834

  Marriage & Family Therapist

  NPD (past)

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

{
    "created_epoch": "1528761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560124800000",
    "number": "1174016422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2365 SHARON RD APT 2",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282111653",
            "telephone_number": "678-471-5302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 PARK RD STE 218B",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282093650",
            "telephone_number": "866-700-1606",
            "fax_number": "866-338-5921"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1077 13th St SE",
            "address_purpose": "LOCATION",
            "city": "Hickory",
            "state": "NC",
            "postal_code": "286024165",
            "country_code": "US",
            "telephone_number": "704-375-6310",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3705 Latrobe Dr Ste 340",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "28211",
            "country_code": "US",
            "telephone_number": "704-364-3989",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCULLOUGH",
        "first_name": "TIFFANY",
        "middle_name": "VILESE",
        "credential": "LMFTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-12",
        "last_updated": "2019-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NC",
            "license": "12099A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harlan A McCulloch, MD
• McCullough Center for Community Services
• Batonya McCullough
• Katherine A a McCullough, PA
• Kathleen Rose McCullough, PA
• Isiah McCullum
• Eleanor Mark McCurdy
• Kathleen Carter McCurdy, MSW, LCSW
• Lewis Hall McCurdy III, MD
• Kathryn Dare McCurry, PA-C

• Marriage & Family Therapist in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Marriage & Family Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2019; 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.