Active NPI
Dustin McCullough
- Social Worker
- Elmira, NY
National Provider Identifier
1306454863
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 127297
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 127297 | NY | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Services of Chemung County, Inc. | Social Worker | Current | 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.