Active NPI
Jennifer McCulloch, LMSW
- Clinical Social Worker
- Ann Arbor, MI
National Provider Identifier
1700238128
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801087066
- Practice address
- 1955 Pauline Blvd
Ann Arbor, MI 48103-5003 - Phone
- (734) 994-9466
- NPI assigned
- Jul 9, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801087066 | MI | Primary |
Addresses
Primary practice location
1955 Pauline Blvd
Ann Arbor, MI 48103-5003
Mailing address
1955 Pauline Blvd
Ann Arbor, MI 48103-5003
Phone (734) 994-9466
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 16, 2025 through Feb 16, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801087066 | MI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468022400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1468022400000",
"number": "1700238128",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1955 PAULINE BLVD",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481035003",
"telephone_number": "734-994-9466"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1955 PAULINE BLVD",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481035003",
"telephone_number": "734-994-9466"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCULLOCH",
"first_name": "JENNIFER",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-07-09",
"last_updated": "2016-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801087066",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.