Blake McCullough, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801104012 Issued in MI

Practice address

2900 Hannah Blvd Ste 104
East Lansing, MI 48823-5380

Phone

(517) 253-6320

NPI assigned

Feb 13, 2018

Last updated

Aug 8, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Edward W Sparrow Hospital AssociationGroup PAC ID 6709799166, shared by 20 NPIs, 698 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Edward W Sparrow Hospital Hospital, Lansing, MI, CCN 230230

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Edward W Sparrow Hospital Association

  dba Sparrow Medical Group East Lansing

  • Family Medicine Physician
  • East Lansing, MI
  • NPI 1124654793
  Medicare reassignment NPD
• Edward W. Sparrow Hospital Association

  dba Sparrow Regional Children's Center

  • Pediatrics Physician
  • Lansing, MI
  • NPI 1831139088
  Medicare reassignment NPD
• Power Through Change LLC

  • Clinical Social Worker
  • Okemos, MI
  • NPI 1134971781
  NPD Authorized official
• Edward W Sparrow Hospital Association

  dba University of Michigan Health-Sparrow

  • Adult Health Nurse Practitioner
  • Lansing, MI
  • NPI 1265220438

  Clinical

  NPD
• Edward W. Sparrow Hospital Association

  dba Sparrow Family Medicine Residency Central

  • Family Medicine Physician
  • Mason, MI
  • NPI 1083668545
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Edward W Sparrow Hospital Association

  dba University of Michigan Health-Sparrow Lansing

  • General Acute Care Hospital
  • Lansing, MI
  • NPI 1073588711
  Care Compare affiliation
• Edward W Sparrow Hospital Association

  dba Thoracic Cardiovascular Institute

  • General Acute Care Hospital
  • Lansing, MI
  • NPI 1760710719
  Care Compare affiliation

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

{
    "created_epoch": "1518480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1679073092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 HANNAH BLVD STE 104",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488235380",
            "telephone_number": "517-253-6320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 HANNAH BLVD STE 104",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488235380",
            "telephone_number": "517-253-6320"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5303 S Cedar St Ste 2",
            "address_purpose": "LOCATION",
            "city": "Lansing",
            "state": "MI",
            "postal_code": "489113800",
            "country_code": "US",
            "telephone_number": "517-346-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4123 Okemos Rd Ste 15",
            "address_purpose": "LOCATION",
            "city": "Okemos",
            "state": "MI",
            "postal_code": "488642818",
            "country_code": "US",
            "telephone_number": "517-243-9738",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCULLOUGH",
        "first_name": "BLAKE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-13",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801100146",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801104012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rya McCann, LMSW
• Hannah McClain McConnell
• Kendra Renea McClaine
• Mackenzie Elizabeth-Rose McClelland
• Lois A. McCrone, M.A., LPC
• Stuart Richard McCullough
• Sandra Jane McCurdy, LM CPM
• Margaret Mae McDonald
• Conor McDonough, ATC
• Perry Lydel McFarland, PT

• Clinical Social Worker in East Lansing, MI
• Providers in East Lansing, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2023; 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.

Verify at the official NPI Registry.