National Provider Identifier
Kecia Lee McCullough, CASAC MASTERS, LMSW
Kecia Lee McCullough, CASAC MASTERS, LMSW is listed in the NPPES registry with a primary specialty of Clinical Social Worker in Orchard Park, NY and a listed phone number of (716) 662-2040.
Profile Overview
- NPI
- 1285037606
- Provider Type
- Individual
- Primary Specialty
- Clinical Social Worker
- Enumeration Date
- September 30, 2014
- Last Updated
- February 29, 2024
Practice Location
- 227 Thorn Ave
- Orchard Park, NY 14127-2600
Phone: (716) 662-2040
Mailing Address
- 45 Gilmore St
- Rochester, NY 14605-1309
Specialties
- Clinical Social Worker (1041C0700X)
- Addiction (Substance Use Disorder) Counselor (101YA0400X)
Full Record
- NPI
- 1285037606
- Entity Type
- Individual
- Last Name
- McCullough
- First Name
- Kecia
- Middle Name
- Lee
- Credential
- CASAC MASTERS, LMSW
- Mailing Street Address
- 45 Gilmore St
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14605-1309
- Mailing Country
- US
- Mailing Phone
- (585) 233-9794
- Practice Street Address
- 227 Thorn Ave
- Practice City
- Orchard Park
- Practice State
- NY
- Practice ZIP Code
- 14127-2600
- Practice Country
- US
- Practice Phone
- (716) 662-2040
- Practice Fax
- (716) 662-0019
- Enumeration Date
- September 30, 2014
- Last Updated
- February 29, 2024
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- June 26, 2021
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Clinical Social Worker (1041C0700X), Addiction (Substance Use Disorder) Counselor (101YA0400X)