Maurissa Nicole McCulloch, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

10294 Issued in SC

Practice address

108 Woodland Creek Way
Travelers Rest, SC 29690-8490

Phone

(864) 640-6825

NPI assigned

Sep 30, 2024

Sex

Female

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

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Upstate Ellie LLC

  • Specialist
  • Greenville, SC
  • NPI 1457073694
  NPD

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

{
    "created_epoch": "1727654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1669290441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 WOODLAND CREEK WAY",
            "city": "TRAVELERS REST",
            "state": "SC",
            "postal_code": "296908490",
            "telephone_number": "864-640-6825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 WOODLAND CREEK WAY",
            "city": "TRAVELERS REST",
            "state": "SC",
            "postal_code": "296908490",
            "telephone_number": "864-640-6825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOCH",
        "first_name": "MAURISSA",
        "middle_name": "NICOLE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-30",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "SC",
            "license": "10294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Logan Elizabeth Martin, DPT
• Benedicto Martinez
• Susan H Maxwell, DMD
• Landrum Irvin McCarrell Jr., M.D.
• Caroline Miller McCauley, OTD, OTR
• Montaree Elise McCurley, LMFT
• Emily McLemore, MSP
• McLeskey Todd Pharmacy of Travelers Rest Inc
• McLeskey Todd Pharmacy of Travelers Rest, Inc
• Taylor Kaitlyn Medlin, PNP-PC

• Professional Counselor in Travelers Rest, SC
• Providers in Travelers Rest, SC by specialty
• Professional Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; 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.