Kecia Lee McCullough, CASAC MASTERS, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

097126 Issued in NY

Practice address

227 Thorn Ave
Orchard Park, NY 14127-2600

Phone

(716) 662-2040

Fax

(716) 662-0019

NPI assigned

Sep 30, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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.

• Kecia L McCullough LCSW Psychotherapy Services PLLC

  • Clinical Social Worker
  • Rochester, NY
  • NPI 1497579874
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1412035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709164800000",
    "number": "1285037606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 GILMORE ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146051309",
            "telephone_number": "585-233-9794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 THORN AVE",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141272600",
            "telephone_number": "716-662-2040",
            "fax_number": "716-662-0019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOUGH",
        "first_name": "KECIA",
        "middle_name": "LEE",
        "credential": "CASAC MASTERS, LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-30",
        "last_updated": "2024-02-29",
        "certification_date": "2021-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "28786",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "097126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alaina Elizabeth McAuliffe-Ferry, D.C
• Jodie McCarthy, LMFT
• Tina Louise McCarty-Neveu, CASAC
• Karen Lynn McClintock, PH.D.
• Elizabeth Mary McCormick, CFMA/SLP
• Molly Anne McCune, LMSW
• Brian Patrick McDonald, DDS
• Patricia McDonald
• Peggy Ann McDonald
• Valerie Ann McDonald, PA

• Clinical Social Worker in Orchard Park, NY
• Providers in Orchard Park, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.