Brian Patrick McCullough, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

310 Issued in MN

Practice address

1801 Nicollet Ave
Minneapolis, MN 55403-3791

Phone

(612) 596-9438

Fax

(612) 879-3824

NPI assigned

Jul 7, 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

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1309996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555027200000",
    "number": "1417244716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 NICOLLET AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554033791",
            "telephone_number": "612-596-9438",
            "fax_number": "612-879-3824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 NICOLLET AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554033791",
            "telephone_number": "612-596-9438",
            "fax_number": "612-879-3824"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1900 Silver Lake Rd NW",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551121786",
            "country_code": "US",
            "telephone_number": "651-379-1718",
            "fax_number": "651-628-0411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCULLOUGH",
        "first_name": "BRIAN",
        "middle_name": "PATRICK",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-07",
        "last_updated": "2019-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gina R McCrone, PA
• Michael Patrick McCue, MD
• Stephanie Noel McCullough-Cain, BCC
• Margy Elise McCullough-Hicks, M.D.
• Betsy Jean McCullough, PSY.D., L.P.C.
• John Jeffrey McCullough, MD
• Kristen McCullough, CNM
• Sarah Lindsey McCullough, CNM, FNP-C
• Martha L McCusker, MD
• Debra Jean McDermott, RN, CNP

• Professional Counselor in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.