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Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

JERRY RUSSELL PENN MCCULLOUGH
NPI 1346154291
Social Worker in Champaign, IL

Active since September 29, 2026
819 BLOOMINGTON RD, CHAMPAIGN, IL 61820(217) 600-7000 Get Directions Write a Review

NPPES record added: September 29, 2026. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Jerry Russell Penn Mccullough NPPES

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

JERRY RUSSELL PENN MCCULLOUGH (NPI 1346154291) is an individual social worker in Champaign, Illinois, licensed in Illinois (150.131752) and active in the NPI registry since September 2026.

NPPES Registry Identity

NPI1346154291
Entity TypeIndividualMale
Primary Taxonomy104100000X
Provider Legal NameJERRY RUSSELL PENN MCCULLOUGH
Location Address819 BLOOMINGTON RDChampaign, IL 61820-2101
Mailing Address403 Briar Ln Apt 115Champaign, IL 61820-2128
Phone(217) 600-7000
Sole ProprietorNo
Enumeration DateSeptember 29, 2026
NPPES CertifiedSeptember 29, 2026
✔ NPI 1346154291 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial WorkerBehavioral Health & Social Service Providers
Taxonomy Code104100000X
License✔ Licensed in IL · 150.131752
Definition
A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.
819 BLOOMINGTON RD, Champaign, IL 61820
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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.

JESSICA LYNN MANDRELL
Nurse Practitioner (Psychiatric/Mental Health)
819 BLOOMINGTON RD
CHAMPAIGN, IL 61820
Champaign County (217) 356-1558
DR. CORINNE E KOHLER MD
Family Medicine
819 BLOOMINGTON RD
CHAMPAIGN, IL 61820
Champaign County (217) 356-1558
RIVER ANDRES PA
Physician Assistant
819 BLOOMINGTON RD
CHAMPAIGN, IL 61820
Champaign County (217) 356-1558
PROMISE HEALTHCARE
Counselor (Mental Health)
819 BLOOMINGTON RD
CHAMPAIGN, IL 61820
Champaign County (217) 356-1558
VALERIE CINTRON
Social Worker (Clinical)
819 BLOOMINGTON RD
CHAMPAIGN, IL 61820
Champaign County (217) 356-1558
JENNY M. DAAB PNP
Nurse Practitioner (Pediatrics)
819 BLOOMINGTON RD
CHAMPAIGN, IL 61820
Champaign County (217) 356-1558
MYOUNGSU SONG
Dentist (General Practice)
819 BLOOMINGTON RD
CHAMPAIGN, IL 61820
Champaign County (217) 356-1558
ABDELKRIM HADJ SAID PH. D.
Counselor (Professional)
819 BLOOMINGTON RD
CHAMPAIGN, IL 61820
Champaign County (217) 356-1558

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 Jerry Mccullough's NPI number?

The NPI number for Jerry Mccullough is 1346154291. It was assigned to this individual provider in the NPPES registry on September 29, 2026.

Where is Jerry Mccullough located?

Jerry Mccullough practices at 819 Bloomington Rd, Champaign, IL 61820. The listed phone number is (217) 600-7000.

What is Jerry Mccullough's specialty?

The primary specialty registered for this NPI is Social Worker with taxonomy code 104100000X.

When was this NPI record last updated?

The NPPES record for Jerry Mccullough was last updated on September 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 days 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.