McCullough Mental Health & Wellness LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

MCCULLOUGH MENTAL HEALTH & WELLNESS LLC

Practice address

3904 Wabash Ave Apt 2a
Baltimore, MD 21215-8358

Phone

(443) 563-1287

NPI assigned

Apr 9, 2021

Last updated

Apr 9, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Shannon McCullough, LGPC, NCCNPI 1891375473

Title

Owner

Phone

(410) 710-4018

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shannon McCullough, LGPC, NCC

  • Mental Health Counselor
  • Baltimore, MD
  • NPI 1891375473
  NPD Authorized official

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

{
    "created_epoch": "1617926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617926400000",
    "number": "1790365260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3904 WABASH AVE APT 2A",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212158358",
            "telephone_number": "443-563-1287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3904 WABASH AVE APT 2A",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212158358",
            "telephone_number": "443-563-1287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCCULLOUGH MENTAL HEALTH & WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-09",
        "last_updated": "2021-04-09",
        "certification_date": "2021-04-08",
        "status": "A",
        "authorized_official_last_name": "MCCULLOUGH",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-710-4018",
        "authorized_official_credential": "LGPC, NCC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colleen B McCreary, C.R.N.A.
• Catherine Anne McCubbin, LCPC
• Courtney McCubbin, LCPC
• Jeffrey Michael McCue, P.A.
• Barbara Ann McCullers, CPHT
• Christopher McCullough, LGPC
• Dawn McCullough, CPHT
• Kristin McCullough, CRNP
• Shannon McCullough, LGPC, NCC
• Rachel Elizabeth McCumbers, C.R.N.P.

• Mental Health Clinic/Center (Including Community Mental Health Center) in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2021; 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.