Stefanie Nicole Marissa Cullum

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

2520 Saint Rose Pkwy Ste 306
Henderson, NV 89074-7790

Phone

(702) 755-2578

NPI assigned

Dec 15, 2020

Last updated

Dec 15, 2020By the provider in NPPES

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

Credentials

Master of Arts

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

{
    "created_epoch": "1607990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607990400000",
    "number": "1699361527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7053 PLACID LAKE AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891791524",
            "telephone_number": "702-755-2578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 SAINT ROSE PKWY STE 306",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890747790",
            "telephone_number": "702-755-2578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CULLUM",
        "first_name": "STEFANIE",
        "middle_name": "NICOLE MARISSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-15",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Cuellar
• Melissa Cuevas
• Annabelle Cuffee
• Gabrial Cullen
• Brynda Jena Cullison, MFT,NCC
• Culpepper DMD PLLC (Excellence in Dentistry)
• Marah Culpepper, DMD
• Medina Victoria Culver, DO
• Tiechaye Culver
• Jaythan Cunico

• Clinical Social Worker in Henderson, NV
• Providers in Henderson, NV by specialty
• Clinical Social Worker in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2020; 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.