Active NPI
Chase McCullough, NLC
- Counseling Psychologist
- Vona, CO
National Provider Identifier
1902331697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- NLC.0109962
- Practice address
- 1215 2ND St
Vona, CO 80861-5002 - Phone
- (719) 349-0413
- NPI assigned
- May 1, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | |||
| Counseling Psychologist | 103TC1900X | NLC.0109962 | CO | Primary |
Addresses
Primary practice location
1215 2ND St
Vona, CO 80861-5002
Mailing address
PO Box 45
Vona, CO 80861-0045
Phone (719) 349-0413
Other practice location 1
1291 Circle Dr
Burlington, CO 80807-1245
Phone (719) 346-8183
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
| License | State | Type | Specialty |
|---|---|---|---|
| NLC.0109962 | CO | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1493596800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630972800000",
"number": "1902331697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 45",
"city": "VONA",
"state": "CO",
"postal_code": "808610045",
"telephone_number": "719-349-0413"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1215 2ND ST",
"city": "VONA",
"state": "CO",
"postal_code": "808615002",
"telephone_number": "719-349-0413"
}
],
"practiceLocations": [
{
"address_1": "1291 Circle Dr",
"address_purpose": "LOCATION",
"city": "Burlington",
"state": "CO",
"postal_code": "808071245",
"country_code": "US",
"telephone_number": "719-346-8183",
"fax_number": "719-346-0292",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MCCULLOUGH",
"first_name": "CHASE",
"credential": "NLC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-05-01",
"last_updated": "2021-09-07",
"certification_date": "2021-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "CO",
"license": "NLC.0109962",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vona, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 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.