Individual provider · Type 1 NPI

Mark Allen McCullough, LCSW

Clinical Social Worker · Boise, ID

NPI number 1932160488 Active

Practice location

5400 W Franklin Road, Suite H
Boise, ID 83705

Call (208) 345-1170 Map

Fax (208) 345-3502

Mailing address

PO Box 9, 211 16th Avenue North
Nampa, ID 83653-0009

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700XLCSW696 (ID)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1932160488

Mark Allen McCullough, LCSW's National Provider Identifier is 1932160488, issued on Mar 31, 2006. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Boise, ID. The record was last updated on Jul 16, 2008.