Individual provider Active NPI

John McCullagh, PHD

  • Counseling Psychologist
  • Brooklyn, NY
National Provider Identifier
1780817916
Registry record updated Jul 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
023722-01 Issued in NY
Practice address
3512 Quentin Rd Ste 110
Brooklyn, NY 11234-4245
Phone
(800) 275-3243
NPI assigned
Sep 4, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Counseling Psychologist 103TC1900X 023722-01 NY Primary

Addresses

Primary practice location

3512 Quentin Rd Ste 110
Brooklyn, NY 11234-4245

Mailing address

145 Morningside Ave Apt 1D
New York, NY 10027-4348
Phone (832) 866-8115

Other practice location 1

67 Mechanic St
Attleboro, MA 02703-2036
Phone (832) 866-8115

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
023722-01NYMDCounseling Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1252022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595376000000",
    "number": "1780817916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 MORNINGSIDE AVE APT 1D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100274348",
            "telephone_number": "832-866-8115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3512 QUENTIN RD STE 110",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112344245",
            "telephone_number": "800-275-3243"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "67 Mechanic St",
            "address_purpose": "LOCATION",
            "city": "Attleboro",
            "state": "MA",
            "postal_code": "027032036",
            "country_code": "US",
            "telephone_number": "832-866-8115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCULLAGH",
        "first_name": "JOHN",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-09-04",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NY",
            "license": "023722-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.