Mrs Kathryn Ellen Mccullough, LCSW in Providence, RI

Mrs Kathryn Ellen Mccullough, LCSW is a medicare enrolled "Counselor - Addiction (substance Use Disorder)" provider in Providence, Rhode Island. Her current practice location is 825 Chalkstone Ave, Providence, Rhode Island. You can reach out to her office (for appointments etc.) via phone at (401) 456-2000.

Mrs Kathryn Ellen Mccullough is licensed to practice in Rhode Island (license number CSW1628) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1578014098.

Contact Information

	Mrs Kathryn Ellen Mccullough, LCSW
	825 Chalkstone Ave, Providence, RI 02908-4728
	(401) 456-2000
	(401) 456-6744

Map and Direction

Healthcare Provider's Profile

Full Name	Mrs Kathryn Ellen Mccullough
Gender	Female
Speciality	Counselor - Addiction (substance Use Disorder)
Location	825 Chalkstone Ave, Providence, Rhode Island
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1578014098
Provider Enumeration Date: 10/19/2016
Last Update Date: 10/19/2016

Medicare PECOS Information:

PECOS PAC ID: 9739308388
Enrollment ID: I20170223000152

Medical Identifiers

Medical identifiers for Mrs Kathryn Ellen Mccullough such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1578014098	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YA0400X	Counselor - Addiction (substance Use Disorder)	CSW1628 (Rhode Island)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Kathryn Ellen Mccullough allows following entities to bill medicare on her behalf.

Entity Name	Prospect Chartercare Sjhsri Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1588089759 PECOS PAC ID: 7315179314 Enrollment ID: O20140722001928

Entity Name	Prospect Chartercare Rwmc, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1285059287 PECOS PAC ID: 0547492696 Enrollment ID: O20140728001672

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Kathryn Ellen Mccullough is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mrs Kathryn Ellen Mccullough, LCSW 120 Roth Rd, Dayville, CT 06241-1416 Ph: (401) 456-2000	Mrs Kathryn Ellen Mccullough, LCSW 825 Chalkstone Ave, Providence, RI 02908-4728 Ph: (401) 456-2000

Reviews and Comments

Counselor in Providence, RI

Olivia Meunier, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 530 N Main St, Providence, RI 02904 Phone: 401-274-2500
Mr. Brian P Shea, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 50 Park Row W, #426, Providence, RI 02903 Phone: 617-455-2788
Alisha Choquette, AA, ACDP Counselor Medicare: Not Enrolled in Medicare Practice Location: 66 Burnett St, Providence, RI 02907 Phone: 401-785-0050 Fax: 401-941-0089
Betsy Riccio, Counselor Medicare: Not Enrolled in Medicare Practice Location: 300 River Ave, Providence, RI 02908 Phone: 401-465-1955
Miss Ashley L Addison, BA, LCDP, CCSP Counselor Medicare: Not Enrolled in Medicare Practice Location: 530 N Main St, Providence, RI 02904 Phone: 401-276-4100
Jennifer Ortiz, Counselor Medicare: Not Enrolled in Medicare Practice Location: 66 Pavilion Ave, Providence, RI 02905 Phone: 401-461-9110
Shane Lima, Counselor Medicare: Not Enrolled in Medicare Practice Location: 66 Pavilion Ave, Providence, RI 02905 Phone: 401-461-9110

Mrs Kathryn Ellen Mccullough, LCSW - Medicare Counselor in Providence, RI