Active NPI
Nyla McCulloch
- Clinical Social Worker
- Wakefield, MA
National Provider Identifier
1477678076
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 105934
- Practice address
- 1 W Water St
Suite 201
Wakefield, MA 01880-2907 - Phone
- (781) 245-8185
- NPI assigned
- Mar 20, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 105934 | MA | Primary |
Addresses
Primary practice location
1 W Water St
Suite 201
Wakefield, MA 01880-2907
Mailing address
1 W Water St
Suite 201
Wakefield, MA 01880-2907
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P04787 | Other | MA | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1982
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
1 W Water St
Suite 201
Wakefield, MA 01880-2930
Phone (781) 245-8185
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 105934 | MA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Commonwealth Pathology Partners, P.C. | Current | Accepting new patients | |
| North Shore Medical Center, Inc. | Current | Accepting new patients | |
| North Shore Medical Center, Inc. | Current | Accepting new patients |
Locations
81 Highland Ave
Salem, MA 01970
Phone (978) 354-4009
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Salem Hospital
- General Acute Care Hospital
- Salem, MA
- NPI 1730121633
-
- Anatomic Pathology & Clinical Pathology Physician
- Salem, MA
- NPI 1114032976
-
dba Salem Hospital
- Psychiatric Hospital Unit
- Salem, MA
- NPI 1417972647
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1477678076",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 W WATER ST",
"address_2": "SUITE 201",
"city": "WAKEFIELD",
"state": "MA",
"postal_code": "018802907"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 W WATER ST",
"address_2": "SUITE 201",
"city": "WAKEFIELD",
"state": "MA",
"postal_code": "018802907",
"telephone_number": "781-245-8185"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCULLOCH",
"first_name": "NYLA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "105934",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "P04787",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Wakefield, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.