Mccullough, Rodney R
Mccullough, Rodney R is an individual health care provider with primary practice located at 170 Thompson Dr Suite 103, Bridgeport WV 26330-2608. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Mccullough, Rodney R can be contacted via phone (304) 842-6609.Contact Information
Primary practice address
170 Thompson Dr Suite 103
Bridgeport WV 26330-2608
Phone: (304) 842-6609
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 774 | West Virginia |
Profile Details
| NPI number | 1093982506 |
|---|---|
| LBN Legal business name | Mccullough, Rodney R |
| Credentials | Master of Arts (MA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 14th, 2008 |
| Last updated | Jul 28th, 2010 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1093982506 | NPPES |
| West Virginia | MEDICAID | 3810012357 |
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