Jessica Cullen

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

5989-125 Issued in WI

Practice address

612 N Randall Ave
Janesville, WI 53545-1958

Phone

(608) 752-7660

NPI assigned

Nov 27, 2013

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

Other names 1

• Jessica Box Former name

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 and National Provider Directory roles.

• Lutheran Social Services of Wisconsin and Upper Michigan, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Janesville, WI
  • NPI 1386719177
  NPD (past)

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

{
    "created_epoch": "1385510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1235569369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 ECLIPSE CTR",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535113550",
            "telephone_number": "608-361-0311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 N RANDALL AVE",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535451958",
            "telephone_number": "608-752-7660"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "74 Eclipse Ctr",
            "address_purpose": "LOCATION",
            "city": "Beloit",
            "state": "WI",
            "postal_code": "535113550",
            "country_code": "US",
            "telephone_number": "608-361-0311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CULLEN",
        "first_name": "JESSICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-27",
        "last_updated": "2022-02-11",
        "certification_date": "2022-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "5989-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "BOX",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jill Crista, ND
• Annika L Crossley, CD
• Ashley A. Crull, PSY.D.
• Marlo M Crump, LPC-IT
• Haley A Cullen, LPC, SAC
• John A Culp, MD
• Cultivating Wellness Services
• Amanda Nichole Cunningham, B.S. SAC-IT
• John Currie
• Stephanie R Curtis, PA-C

• Professional Counselor in Janesville, WI
• Providers in Janesville, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2022; 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.