Individual provider · Type 1 NPI

Jerry Russell Penn McCullough

Social Worker · Champaign, IL

NPI number 1346154291 Active

Practice location

819 Bloomington Rd
Champaign, IL 61820-2101

Call (217) 600-7000 Map

Mailing address

403 Briar Ln Apt 115
Champaign, IL 61820-2128

Specialties and licenses

TaxonomyCodeLicense
Social Worker Primary 104100000X150.131752 (IL)

Social Worker: 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.

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About NPI 1346154291

Jerry Russell Penn McCullough's National Provider Identifier is 1346154291, issued on Sep 29, 2026. The primary taxonomy on file is Social Worker (104100000X), and the practice location is in Champaign, IL. The record was last updated on Sep 29, 2026.