Individual provider Active NPI

Dustin McCullough

  • Social Worker
  • Elmira, NY
National Provider Identifier
1306454863
Registry record updated Jan 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
127297 Issued in NY
Practice address
1019 E Water St
Elmira, NY 14901-3332
Phone
(607) 733-5696
NPI assigned
Jul 21, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 127297 NY Primary

Addresses

Primary practice location

1019 E Water St
Elmira, NY 14901-3332

Mailing address

1019 E Water St
Elmira, NY 14901-3332
Phone (607) 733-5696

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
127297NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Family Services of Chemung County, Inc. Social Worker CurrentSince Aug 2, 2020 Accepting new patients

Locations

1019 E Water St
Elmira, NY 14901
Phone (607) 733-5696

310 Pennsylvania Ave
Elmira, NY 14904
Phone (607) 733-2820

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1595289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767657600000",
    "number": "1306454863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 E WATER ST",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149013332",
            "telephone_number": "607-733-5696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1019 E WATER ST",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149013332",
            "telephone_number": "607-733-5696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOUGH",
        "first_name": "DUSTIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-21",
        "last_updated": "2026-01-06",
        "certification_date": "2026-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "127297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmira, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2026; 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.