Patrick James McCullagh

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

07787-L Issued in NV

Practice address

2887 S Maryland Pkwy
Las Vegas, NV 89109-1511

Phone

(702) 474-4104

NPI assigned

Oct 7, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1412640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1851794622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2887 S MARYLAND PKWY",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891091511",
            "telephone_number": "702-474-4104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2887 S MARYLAND PKWY",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891091511",
            "telephone_number": "702-474-4104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLAGH",
        "first_name": "PATRICK",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-10-07",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NV",
            "license": "07787-L",
            "primary": true
        },
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany McCree
• Steven Gregory McCuch, DPT
• Shannon McCuddy
• Stefanie McCue
• Madison R McCuistion
• Markysha McCullah
• Aniya McCullam
• Cherisse Ann McCullers, COUNSELOR
• Douglas McCullers
• Anthony Paul McCulloch-Howard

• Addiction (Substance Use Disorder) Counselor in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Addiction (Substance Use Disorder) Counselor in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2024; 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.