Bettina McCulloch, MSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

904 East Martin Luther King Drive
Centralia, IL 62801

Phone

(618) 533-1391

NPI assigned

Mar 10, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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": "1425945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425945600000",
    "number": "1477946804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 EAST MARTIN LUTHER KING DRIVE",
            "city": "CENTRALIA",
            "state": "IL",
            "postal_code": "62801",
            "telephone_number": "618-533-1391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 EAST MARTIN LUTHER KING DRIVE",
            "city": "CENTRALIA",
            "state": "IL",
            "postal_code": "62801",
            "telephone_number": "618-533-1391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOCH",
        "first_name": "BETTINA",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-10",
        "last_updated": "2015-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dana Lee Mathis, D.C.
• Robin Lynn Matthews, CADC
• Destin Lloyd Mays, LCSW, ACSW
• Jennifer Michelle Mazanek
• Carol Lynn McCrary
• Martell McDaniel
• Angie Kay McDuffie
• Rebecca Lynn McElhose, DNP
• McKenzie McKay, PHARMD
• Carolyn K McMurphy-Quick, PA

• Mental Health Counselor in Centralia, IL
• Providers in Centralia, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2015; 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.