KELLEY D MCCULLOUGH
NPI 1104558048
Social Worker - Clinical in Los Angeles, CA

Active since June 29, 2022
3862 S REDONDO BLVD, LOS ANGELES, CA 90008(310) 350-4350 Get Directions Write a Review

NPPES record last updated: June 29, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kelley D Mccullough NPPES

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

KELLEY D MCCULLOUGH (NPI 1104558048) is an individual clinical provider in Los Angeles, California, licensed in California (LCSW107966) and active in the NPI registry since June 2022.

NPPES Registry Identity

NPI1104558048
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameKELLEY D MCCULLOUGH
Location Address3862 S REDONDO BLVDLos Angeles, CA 90008-1113
Mailing Address3862 S Redondo BlvdLos Angeles, CA 90008-1113 · (310) 350-4350
Sole ProprietorYes
Enumeration DateJune 29, 2022
NPPES CertifiedJune 22, 2022
NPI 1104558048 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 CA · LCSW107966
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.
3862 S REDONDO BLVD, Los Angeles, CA 90008

Other Providers at the Same Location NPPES

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

Occupational Therapist
3862 S REDONDO BLVD
LOS ANGELES, CA 90008

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 Kelley Mccullough's NPI number?

The NPI number for Kelley Mccullough is 1104558048. It was assigned to this individual provider in the NPPES registry on June 29, 2022.

Where is Kelley Mccullough located?

Kelley Mccullough practices at 3862 S Redondo Blvd, Los Angeles, CA 90008. The listed phone number is (310) 350-4350.

What is Kelley Mccullough'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 Kelley Mccullough was last updated on June 29, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.