Individual provider Active NPI

Catherine McCullum

  • Social Worker
  • Fryeburg, ME
National Provider Identifier
1508171844
Registry record updated Aug 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
LM10647 Issued in ME
Practice address
25 Molly Ockett Dr
Fryeburg, ME 04037-1496
Phone
(207) 935-2401
Fax
(207) 935-4470
NPI assigned
Aug 11, 2010
Last updated
Aug 11, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X LM10647 ME Primary

Addresses

Primary practice location

25 Molly Ockett Dr
Fryeburg, ME 04037-1496

Mailing address

25 Molly Ockett Dr
Fryeburg, ME 04037-1496
Phone (207) 935-2401

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LM10647MEMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1281484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281484800000",
    "number": "1508171844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 MOLLY OCKETT DR",
            "city": "FRYEBURG",
            "state": "ME",
            "postal_code": "040371496",
            "telephone_number": "207-935-2401",
            "fax_number": "207-935-4470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 MOLLY OCKETT DR",
            "city": "FRYEBURG",
            "state": "ME",
            "postal_code": "040371496",
            "telephone_number": "207-935-2401",
            "fax_number": "207-935-4470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLUM",
        "first_name": "CATHERINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-11",
        "last_updated": "2010-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ME",
            "license": "LM10647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fryeburg, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2010; 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.