Julian Rafferty McCullough, PHD, LPC, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MX61291003 Issued in WA

Practice address

1307 NE 43Rd St
Vancouver, WA 98663-3619

Phone

(206) 898-9421

NPI assigned

Jul 7, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Dr. Rafe McCullough Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

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.

• Piiq Space PC

  • Mental Health Counselor
  • Seattle, WA
  • NPI 1295276251
  NPD (past)

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

{
    "created_epoch": "1657152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657152000000",
    "number": "1265165153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1307 NE 43RD ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986633619",
            "telephone_number": "206-898-9421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1307 NE 43RD ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986633619",
            "telephone_number": "206-898-9421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOUGH",
        "first_name": "JULIAN",
        "middle_name": "RAFFERTY",
        "name_prefix": "Dr.",
        "credential": "PHD, LPC, LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-07",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C5864",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "LPC009458",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MX61291003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RAFE",
            "last_name": "MCCULLOUGH",
            "prefix": "DR.",
            "credential": "PHD, LPC, LMHC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Brandi McCreight
• William H McCreight, MD
• Brandon James McCuistion, D.C.
• Meghan Kori McCullers, MD
• John McCulloch
• Rose Marie McCullough, RDH
• Taylor McCullough
• Caitlin McCurdy Mears, MS, CCC-SLP
• Danielle McDade, LMHC, NCC
• Joshua McDermott, SUDPT

• Mental Health Counselor in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 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.