Elliot Paradis McCullough, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

104664 Issued in NY

Practice address

116 Nassau St
3Rd FL
New York, NY 10038-2402

Phone

(212) 416-5629

NPI assigned

Sep 4, 2021

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

State licenses

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

{
    "created_epoch": "1630713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630713600000",
    "number": "1417625260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 WESTMINSTER RD APT 2K",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112182828",
            "telephone_number": "917-596-7338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 NASSAU ST",
            "address_2": "3RD FL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100382402",
            "telephone_number": "212-416-5629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOUGH",
        "first_name": "ELLIOT",
        "middle_name": "PARADIS",
        "name_prefix": "Mr.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-04",
        "last_updated": "2021-09-04",
        "certification_date": "2021-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "104664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carrin McCulloch, MD
• Margot McCulloch, LCSW
• Megan McCulloch
• Melinda L McCulloch, LCSW
• Danielle McCullough, M.D.
• Gene P McCullough, RN,NP
• Hayley McCullough, DO
• Mackenzie McCullough
• Madison Zara McCullough, LCSW
• Marie Booker McCullough, NP

• Clinical Social Worker in New York, NY
• Providers in New York, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2021; 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.