Lisa McCullough, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

39465 Issued in CA

Practice address

23440 Civic Center Way
Malibu, CA 90265-4854

Phone

(310) 457-5250

NPI assigned

Jun 28, 2016

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

Enrolled in CA

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

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 and National Provider Directory roles.

• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Woodland Hills, CA
  • NPI 1952333478
  NPD

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

{
    "created_epoch": "1467072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467072000000",
    "number": "1679924831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23440 CIVIC CENTER WAY",
            "city": "MALIBU",
            "state": "CA",
            "postal_code": "902654854",
            "telephone_number": "310-457-5250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23440 CIVIC CENTER WAY",
            "city": "MALIBU",
            "state": "CA",
            "postal_code": "902654854",
            "telephone_number": "310-457-5250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOUGH",
        "first_name": "LISA",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-28",
        "last_updated": "2016-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "39465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maugeri and Chinn, a Chiropractic Corporation
• Ronald Charles Maugeri, D.C.
• Hussam Yaser Mawari, MD
• Carol Ann MC Cabe, B.S.
• Courtney McCaul, PSY. D.
• Patricia McDermott, M.D.
• Kiley Ann McGill
• Andrea McGovern, MS MFT
• Sydney Dodge McIlvain, LCGC
• Kellye D McKinna, PHD

• Marriage & Family Therapist in Malibu, CA
• Providers in Malibu, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2016; 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.