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MS. MARY ANGELA MACCULLOCH LCSW
NPI 1023369675
Social Worker - Clinical in Fort Drum, NY

Active since September 23, 2012
11050 MOUNT BELVEDERE BLVD, FORT DRUM, NY 13602(315) 772-7624 Get Directions Write a Review

NPPES record last updated: November 22, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 22, 2024, Oct 25, 2022 (2 updates tracked since 2022).

About Ms. Mary Angela Macculloch Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. MARY ANGELA MACCULLOCH LCSW (NPI 1023369675) is an individual clinical provider in Fort Drum, New York, licensed in New York (075757-1) and active in the NPI registry since September 2012.

NPPES Registry Identity

NPI1023369675
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameMS. MARY ANGELA MACCULLOCHCredential: LCSW
Location Address11050 MOUNT BELVEDERE BLVDFort Drum, NY 13602-5438
Mailing Address11050 Mount Belvedere BlvdFort Drum, NY 13602-5438 · (315) 772-7624
Phone(315) 772-7624
Sole ProprietorNo
Enumeration DateSeptember 23, 2012
Last NPPES UpdateNovember 22, 20242 updates tracked since enumeration
NPPES CertifiedNovember 21, 2024
✔ NPI 1023369675 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in NY · 075757-1
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
11050 MOUNT BELVEDERE BLVD, Fort Drum, NY 13602
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. LAUREL JARVIS PH.D.
Psychologist (Clinical)
11050 MOUNT BELVEDERE BLVD, BEHAVIORAL HEALTH DEPARTMENT, MEDDAC
FORT DRUM, NY 13602
Jefferson County (315) 772-4850
DAVID LEWIS KEYES RPA-C
Physician Assistant
11050 MOUNT BELVEDERE BLVD, USA MEDDAC CREDENTIALS
FORT DRUM, NY 13602
Jefferson County (315) 772-5508
BRADY SIMPKINS PA-C
Physician Assistant
11050 MOUNT BELVEDERE BLVD
FORT DRUM, NY 13602
Jefferson County (802) 258-0301
DR. ISAAC P MILLS DO
Family Medicine
11050 MOUNT BELVEDERE BLVD
FORT DRUM, NY 13602
Jefferson County (315) 772-2778
SAVITRI MOTAPARTHI M.D.
Pediatrics
11050 MOUNT BELVEDERE BLVD, USA MEDDAC /CREDENTIALS
FORT DRUM, NY 13602
Jefferson County (315) 772-4025
DR. LUTHER ROSWELL WIEST D.O.
Family Medicine
11050 MOUNT BELVEDERE BLVD
FORT DRUM, NY 13602
Jefferson County (315) 772-3679
MADISON GERMAN LCSW
Social Worker (Clinical)
11050 MOUNT BELVEDERE BLVD
FORT DRUM, NY 13602
Jefferson County (315) 772-2778
DR. DAVID ANDREW PAUL
Optometrist
11050 MOUNT BELVEDERE BLVD, USA MEDDAC/CREDENTIALS
FORT DRUM, NY 13602
Jefferson County (315) 772-4025

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mary Macculloch's NPI number?

The NPI number for Mary Macculloch is 1023369675. It was assigned to this individual provider in the NPPES registry on September 23, 2012.

Where is Mary Macculloch located?

Mary Macculloch practices at 11050 Mount Belvedere Blvd, Fort Drum, NY 13602. The listed phone number is (315) 772-7624.

What is Mary Macculloch's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

When was this NPI record last updated?

The NPPES record for Mary Macculloch was last updated on November 22, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.