Mccullough, Mary Irene

Mccullough, Mary Irene is an sole proprietor health care provider with primary practice located at 11757 Katy Fwy Ste 1300 , Houston TX 77079-1725. She recently has 5 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / School, Behavioral Health & Social Service Providers / Mental Health, Agencies / Case Management. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Mccullough, Mary Irene can be contacted via phone (832) 429-4917.

Contact Information

Primary practice address
11757 Katy Fwy Ste 1300 Houston TX 77079-1725
Phone: (832) 429-4917
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X 64887 Texas
Behavioral Health & Social Service Providers / Professional 101YP2500X 64887 Texas
Behavioral Health & Social Service Providers / School 101YS0200X 64887 Texas
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 64887 Texas
Agencies / Case Management 251B00000X 64887 Texas

Profile Details

NPI number 1699039933
LBN Legal business name Mccullough, Mary Irene
Credentials LSSP, LPC-S, NCC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 2nd, 2012
Last updated Jul 22nd, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699039933 NPPES
Texas MEDICAID 300235402

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