Individual provider Active NPI

Heidi McCullough, LMFT

  • Marriage & Family Therapist
  • West Dundee, IL
National Provider Identifier
1770324592
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
166.001754 Issued in IL
Practice address
501 W Main St
West Dundee, IL 60118-2023
Phone
(262) 448-6811
NPI assigned
Jun 5, 2024
Last updated
May 1, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 166.001754 IL Primary

Addresses

Primary practice location

501 W Main St
West Dundee, IL 60118-2023

Mailing address

501 W Main St
West Dundee, IL 60118-2023
Phone (262) 448-6811

Other practice location 1

27 Grant St
Crystal Lake, IL 60014-4372
Phone (262) 448-6811

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
166.001754ILMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Anew Path-Counseling & Wellness Center PLLC Marriage & Family Therapist CurrentSince May 4, 2025 Accepting new patients
Blair Counseling and Mediation PC Marriage & Family Therapist PastSince Jan 19, 2025 Accepting new patients
New Hope Counseling Center LTD Marriage & Family Therapist PastSince Aug 17, 2025 Accepting new patients

Locations

501 W Main St
West Dundee, IL 60118
Phone (262) 448-6811

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1717545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746057600000",
    "number": "1770324592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 W MAIN ST",
            "city": "WEST DUNDEE",
            "state": "IL",
            "postal_code": "601182023",
            "telephone_number": "262-448-6811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 W MAIN ST",
            "city": "WEST DUNDEE",
            "state": "IL",
            "postal_code": "601182023",
            "telephone_number": "262-448-6811"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27 Grant St",
            "address_purpose": "LOCATION",
            "city": "Crystal Lake",
            "state": "IL",
            "postal_code": "600144372",
            "country_code": "US",
            "telephone_number": "262-448-6811",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCULLOUGH",
        "first_name": "HEIDI",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-05",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": "166.001754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Dundee, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2025; 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.