Patrick James McCullough, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

4606 Issued in OR

Practice address

11395 NW McCoin Rd
Prineville, OR 97754-8287

Phone

(541) 410-0430

NPI assigned

Jun 9, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1307577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307577600000",
    "number": "1346535119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11395 NW MCCOIN RD",
            "city": "PRINEVILLE",
            "state": "OR",
            "postal_code": "977548287",
            "telephone_number": "541-410-0430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11395 NW MCCOIN RD",
            "city": "PRINEVILLE",
            "state": "OR",
            "postal_code": "977548287",
            "telephone_number": "541-410-0430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOUGH",
        "first_name": "PATRICK",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-09",
        "last_updated": "2011-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "4606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Jean Mazac
• Terri Lee McBride, BSN
• Deneice McCallister
• William C McClure, D.D.S.
• Julia Zhukov McCormick, PHARMD
• Julie Ann McCutchen, QMHA
• Breann McFarlane
• Jacalyn Rose McKenzie, CADC CANDIDATE
• Bonnie McMillan
• Rob McQueen-Jensen

• Clinical Social Worker in Prineville, OR
• Providers in Prineville, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2011; 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.