Individual provider Active NPI

Marla Suzanne McCulloch, MSS, LCSW, CEAP

  • Clinical Social Worker
  • King of Prussia, PA
National Provider Identifier
1942239934
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW-014888 Issued in PA
Practice address
114 Crockett Rd
King of Prussia, PA 19406-3014
Phone
(610) 716-1136
NPI assigned
Jul 1, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CW-014888 PA Primary

Addresses

Primary practice location

114 Crockett Rd
King of Prussia, PA 19406-3014

Mailing address

538 Washington Ave
Media, PA 19063-3919
Phone (610) 716-1136

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060213000150 PA Practitioner - Clinical Social Worker 2567476161 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CW-014888PAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Delaware County Professional Services, Inc CurrentSince Dec 23, 2019 Accepting new patients
Holcomb Associates, Inc. CurrentSince Jan 18, 2019 Accepting new patients
Owl Insights Clinical Services LLC Clinical Current Accepting new patients
Holcomb Associates, Inc. Current Accepting new patients
Holcomb Associates, Inc CurrentSince Jan 18, 2019 Accepting new patients

Locations

467 Creamery Way
Exton, PA 19341
Phone 61036314882136

600 Evergreen Dr
Ste 103
Glen Mills, PA 19342
Phone (267) 857-4864

920 E Baltimore Pike
Kennett Square, PA 19348
Phone (610) 388-7400

1055 E Baltimore Pike
Ste 300
Media, PA 19063
Phone (253) 346-0020

1055 E Baltimore Pike
Ste 303
Media, PA 19063
Phone (267) 807-3169

780 E Market St
West Chester, PA 19382
Phone (425) 908-0237

Interoperability endpoints

  • Direct secure messaging: dcp.marlamcculloch@141748.advancedmd-direct.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942239934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "538 WASHINGTON AVE",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190633919",
            "telephone_number": "610-716-1136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 CROCKETT RD",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194063014",
            "telephone_number": "610-716-1136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOCH",
        "first_name": "MARLA",
        "middle_name": "SUZANNE",
        "name_prefix": "Ms.",
        "credential": "MSS, LCSW, CEAP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW-014888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in King of Prussia, PA

Sources for this page

Verify at the official NPI Registry.