1. Home
  2. Directory
  3. Alaska
  4. Fairbanks
  5. Counselor
  6. NPI Profile

JALON ALEXANDER MCCULLOUGH
NPI 1104438365
Counselor - Addiction (Substance Use Disorder) in Fairbanks, AK

Active since August 19, 2020
542 4TH AVE STE B-101, FAIRBANKS, AK 99701(907) 374-1097(907) 374-1062 Get Directions Write a Review

NPPES record last updated: August 19, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jalon Alexander Mccullough NPPES

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

JALON ALEXANDER MCCULLOUGH (NPI 1104438365) is an individual addiction (substance use disorder) provider in Fairbanks, Alaska and active in the NPI registry since August 2020.

NPPES Registry Identity

NPI1104438365
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameJALON ALEXANDER MCCULLOUGH
Location Address542 4TH AVE STE B-101Fairbanks, AK 99701-4707
Mailing AddressPo Box 73004Fairbanks, AK 99707-3004 · (907) 374-1097 · Fax (907) 374-1062
Phone(907) 374-1097
Fax(907) 374-1062
Sole ProprietorNo
Enumeration DateAugust 19, 2020
NPPES CertifiedAugust 19, 2020
✔ NPI 1104438365 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
542 4TH AVE STE B-101, Fairbanks, AK 99701
Open in Google Maps ↗

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 Jalon Mccullough's NPI number?

The NPI number for Jalon Mccullough is 1104438365. It was assigned to this individual provider in the NPPES registry on August 19, 2020.

Where is Jalon Mccullough located?

Jalon Mccullough practices at 542 4th Ave Ste B-101, Fairbanks, AK 99701. The listed phone number is (907) 374-1097.

What is Jalon Mccullough's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Jalon Mccullough was last updated on August 19, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.