1. Home
  2. Directory
  3. Rhode Island
  4. Providence
  5. Counselor
  6. NPI Profile

MRS. KATHRYN ELLEN MCCULLOUGH LCSW
NPI 1578014098
Counselor - Addiction (Substance Use Disorder) in Providence, RI

Active since October 19, 2016PECOS Enrolled
825 CHALKSTONE AVE, PROVIDENCE, RI 02908(401) 456-2000(401) 456-6744 Get Directions Write a Review

NPPES record last updated: October 19, 2016. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Mrs. Kathryn Ellen Mccullough Lcsw NPPES

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

MRS. KATHRYN ELLEN MCCULLOUGH LCSW (NPI 1578014098) is an individual addiction (substance use disorder) provider in Providence, Rhode Island, licensed in Rhode Island (CSW1628) and active in the NPI registry since October 2016. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1578014098
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
Provider Legal NameMRS. KATHRYN ELLEN MCCULLOUGHCredential: LCSW
Location Address825 CHALKSTONE AVEProvidence, RI 02908-4728
Mailing Address120 Roth RdDayville, CT 06241-1416 · (401) 456-2000 · Fax (401) 456-6744
Phone(401) 456-2000
Fax(401) 456-6744
Sole ProprietorYes
Enumeration DateOctober 19, 2016
✔ NPI 1578014098 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
License✔ Licensed in RI · CSW1628
825 CHALKSTONE AVE, Providence, RI 02908
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Kathryn Ellen Mccullough Lcsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Kathryn Mccullough reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Prospect Chartercare Rwmc, LLC
Same address
Internal Medicine
825 CHALKSTONE AVE
Providence, RI 02908
  • Reassigned Medicare billing, Rhode Island enrollment
  • 162 clinicians in this Medicare group
NPI 1285059287 (401) 456-2000
Prospect Chartercare Sjhsri, LLC
2.0 mi
Internal Medicine
200 HIGH SERVICE AVE
North Providence, RI 02904
  • Reassigned Medicare billing, Rhode Island enrollment
  • 110 clinicians in this Medicare group
NPI 1588089759 (401) 456-3000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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. TODD F ROBERTS MD
Internal Medicine (Medical Oncology)
825 CHALKSTONE AVE
PROVIDENCE, RI 02908
Providence County (401) 456-6565
DR. WILLIAM ARTHUR YELLE MD
Anesthesiology
825 CHALKSTONE AVE
PROVIDENCE, RI 02908
Providence County (401) 456-2000
IAN M JACOBSON MD
Emergency Medicine
825 CHALKSTONE AVE
PROVIDENCE, RI 02908
Providence County (330) 493-4443
PROSPECT CHARTERCARE RWMC, LLC
General Acute Care Hospital
825 CHALKSTONE AVE
PROVIDENCE, RI 02908
Providence County (401) 456-2000
N PETER LIBBEY M.D.
Pathology (Anatomic Pathology)
825 CHALKSTONE AVE, ROGER WILLIAMS MEDICAL CENTER/PATHOLOGY DEPT.
PROVIDENCE, RI 02908
Providence County (401) 456-2162
GARRICK MARK WHITLOCK CRNA
Nurse Anesthetist, Certified Registered
825 CHALKSTONE AVE
PROVIDENCE, RI 02908
Providence County (401) 456-2000
VALERIE JEAN ZUERCHER
Social Worker (Clinical)
825 CHALKSTONE AVE
PROVIDENCE, RI 02908
Providence County (401) 456-4807
MAIMOONA HAROON MEMON MD
Internal Medicine
825 CHALKSTONE AVE
PROVIDENCE, RI 02908
Providence County (401) 456-2000

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 Kathryn Mccullough's NPI number?

The NPI number for Kathryn Mccullough is 1578014098. It was assigned to this individual provider in the NPPES registry on October 19, 2016.

Where is Kathryn Mccullough located?

Kathryn Mccullough practices at 825 Chalkstone Ave, Providence, RI 02908. The listed phone number is (401) 456-2000.

What is Kathryn Mccullough's specialty?

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

Is Kathryn Mccullough enrolled in Medicare?

Yes. Kathryn Mccullough is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Kathryn Mccullough's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kathryn Mccullough reassigns Medicare benefits to 2 organizations: Prospect Chartercare Rwmc, LLC (Providence, RI) and Prospect Chartercare Sjhsri, LLC (North Providence, RI). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kathryn Mccullough's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Kathryn Mccullough was last updated on October 19, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.