Stephanie Christine McCulloch

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

37AC00456600 Issued in NJ

Practice address

1157 Main Ave
Clifton, NJ 07011-2243

Phone

(973) 341-9869

NPI assigned

Oct 14, 2020

Last updated

Oct 14, 2020By the provider in NPPES

Sex

Female

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

State licenses

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

{
    "created_epoch": "1602633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602633600000",
    "number": "1396343075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 DELAWARE PL APT 3",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070034771",
            "telephone_number": "973-809-9550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1157 MAIN AVE",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070112243",
            "telephone_number": "973-341-9869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOCH",
        "first_name": "STEPHANIE",
        "middle_name": "CHRISTINE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-14",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37AC00456600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evelyn Mazloom
• Christopher E Mazzo, D.C.
• Mba MD
• Michael R MC Master, P.A.
• MCB Professionals LLC (Yasmen Eissa)
• Josette McDaniel
• Coleen Shannon McDonald, PA-C
• John Joseph McEvoy Jr., DPM
• Douglas Dean McGuire, DMD
• Tecoya McKelvey

• Professional Counselor in Clifton, NJ
• Providers in Clifton, NJ by specialty
• Professional Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2020; 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.