Rodney R Mccullough, MA | |
170 Thompson Dr, Suite 103, Bridgeport, WV 26330-2608 | |
(304) 842-6609 | |
Not Available |
Full Name | Rodney R Mccullough |
---|---|
Gender | Male |
Speciality | Psychologist |
Location | 170 Thompson Dr, Bridgeport, West Virginia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1093982506 | NPI | - | NPPES |
3810012357 | Medicaid | WV |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103T00000X | Psychologist | 774 (West Virginia) | Primary |
Entity Name | Banyan Tree Counseling Group |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1689185704 PECOS PAC ID: 1153680343 Enrollment ID: O20180116001072 |
Mailing Address | Practice Location Address |
---|---|
Rodney R Mccullough, MA Po Box 271, Worthington, WV 26591-0271 Ph: (304) 657-1656 | Rodney R Mccullough, MA 170 Thompson Dr, Suite 103, Bridgeport, WV 26330-2608 Ph: (304) 842-6609 |
Ms. Narine Karakashian, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 114 Ventura Dr, Bridgeport, WV 26330 Phone: 302-399-8325 | |
Mr. Robert Victor Leydon, M.A. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 141 State St, Bridgeport, WV 26330 Phone: 304-842-6609 Fax: 304-842-6619 | |
Mary Kristi Williams, M.A. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 231 Davis St, Bridgeport, WV 26330 Phone: 304-842-0044 Fax: 304-842-0033 | |
Dr. Amy Nicole Hebb, PSY.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 65 Professional Place, Suite 101, Bridgeport, WV 26330 Phone: 304-842-6463 Fax: 304-842-8180 | |
Jeffery S Collins, MA Psychologist Medicare: Not Enrolled in Medicare Practice Location: 917 W Main St, Suite 203, Bridgeport, WV 26330 Phone: 304-842-7007 Fax: 304-842-7099 | |
Michelle Lee Wetzel, MA Psychologist Medicare: Not Enrolled in Medicare Practice Location: 917 W Main St, Suite 203, Bridgeport, WV 26330 Phone: 304-842-7007 Fax: 304-842-7099 |