Active NPI
Donna C. Culley, PH.D., HSPP
- Clinical Psychologist
- Evansville, IN
National Provider Identifier
1205160603
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 20042379A
- Practice address
- 415 Mulberry Street
Evansville, IN 47713-1230 - Phone
- (812) 423-7791
- Fax
- (812) 422-7558
- NPI assigned
- Oct 1, 2009
- Last updated
- Oct 9, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 20042379A | IN | Primary |
| Forensic Psychologist | 103TF0200X | 20042379A | IN |
Addresses
Primary practice location
415 Mulberry Street
Evansville, IN 47713-1230
Mailing address
415 Mulberry Street
Evansville, IN 47713-1230
Phone (812) 423-7791
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200967750 | Medicaid | IN | |
| 000000640783 | Other | IN | ANTHEM |
| 20042379A | Other | IN | LICENSE - PSYCHOLOGIST |
| 12018783 | Other | IN | CAQH |
| 20042379A | Other | IN | LICENSE - HSPP |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20042379A | IN | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1254355200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444348800000",
"number": "1205160603",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "415 MULBERRY STREET",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477131230",
"telephone_number": "812-423-7791",
"fax_number": "812-422-7558"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "415 MULBERRY STREET",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477131230",
"telephone_number": "812-423-7791",
"fax_number": "812-422-7558"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CULLEY",
"first_name": "DONNA",
"middle_name": "C.",
"name_prefix": "Ms.",
"credential": "PH.D., HSPP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-10-01",
"last_updated": "2015-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IN",
"license": "20042379A",
"primary": true
},
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": "IN",
"license": "20042379A",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200967750",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000640783",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE - PSYCHOLOGIST",
"identifier": "20042379A",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "12018783",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE - HSPP",
"identifier": "20042379A",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Evansville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.