Spencer McCullough, LPC
Individual provider Active NPI Professional Counselor · El Dorado, AR
NPI 1851754972 · NPPES record last updated Jul 15, 2019
Key facts
- NPI
- 1851754972
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- P1710366 (AR)
- Practice address
- 600 S Timberlane Dr
El Dorado, AR 71730-6990 - Phone
- (870) 862-2400
- Fax
- (870) 862-1891
- NPI assigned
- Apr 5, 2016
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A1602028 | AR | MD | Mental Health Counselor |
| P1710366 | AR | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | A1602028 | AR | |
| Professional Counselor | 101YP2500X | P1710366 | AR | Yes |
Addresses
Primary practice location
600 S Timberlane Dr
El Dorado, AR 71730-6990
Mailing address
125 Wellness Way
Hot Springs, AR 71913-6478
Phone (501) 624-7111
Other practice location 1
2213 N Reynolds Rd Ste 1
Bryant, AR 72022-2501
Phone (501) 847-0081
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 218243795 | Medicaid | AR |
Other names
- Mrs. Spencer Whitley
Other providers in El Dorado, AR
- Damaris Maxfield
- Lisa McAdams
- Kasey Leigh McClain
- Lance McCoy
- Lauren McCoy
- Laura Linn McDill
- Chase McDonald
- Morgan Lee McDonald
- Teresa Post McDonald
- Keitonya McGhee
All providers in El Dorado, AR · Professional Counselor in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 15, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.