MS. JANA LYNN MCCULLOCH (NPI# 1275002081) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275002081 |
| Entity Type | Individual |
| Full Name | MS. JANA LYNN MCCULLOCH |
| Credential | AAC |
| Practice Address |
2204 Pacific Ave N Long Beach WA 98631-3300 |
| Practice Telephone | 3602187065 |
| Mailing Telephone | 3602187065 |
| Enumeration Date | 2018-11-21 |
| Last Update Date | 2018-11-21 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | 60894410 | WA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 1174570949 | 05 |
| Street Address |
2204 PACIFIC AVE N |
| City | LONG BEACH |
| State | WA |
| Zip Code | 98631-3300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174570949 | Willapa Counseling Center | Clinic/Center | 2204 Pacific Ave N, Long Beach, WA 98631-3300 | 2006-05-27 |
| 1760008783 | Willapa Counseling Center | General Practice | 2204 Pacific Ave N, Long Beach, WA 98631-3300 | 2020-06-25 |
| 1114542503 | Sarah Wheat | Social Worker | 2204 Pacific Ave N, Long Beach, WA 98631-3300 | 2020-06-10 |
| 1629691191 | Melodie Nichelle Presler | Peer Specialist | 2204 Pacific Ave N, Long Beach, WA 98631-3300 | 2020-05-19 |
| 1184245565 | Michael Nolan | Counselor | 2204 Pacific Ave N, Long Beach, WA 98631-3300 | 2020-04-27 |
| 1598398067 | Cassaundra Cretian | Counselor | 2204 Pacific Ave N, Long Beach, WA 98631-3300 | 2020-02-12 |
| 1396381083 | Tysha Marie Wirkkala | Counselor | 2204 Pacific Ave N, Long Beach, WA 98631-3300 | 2019-11-18 |
| 1417590324 | Arielle Stewart | Peer Specialist | 2204 Pacific Ave N, Long Beach, WA 98631-3300 | 2019-10-23 |
| 1841841152 | John Williams | Counselor | 2204 Pacific Ave N, Long Beach, WA 98631-3300 | 2019-09-27 |
| 1184275265 | Marisa Elizabeth Maul | Counselor | 2204 Pacific Ave N, Long Beach, WA 98631-3300 | 2019-09-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063048197 | Peninsula Pharmacies Inc Long Beach Pharmacy Annex | Pharmacy | 110 Oregon Ave S, Long Beach, WA 98631 | 2020-03-20 |
| 1033755244 | Willapa Behavioral Health | Peer Specialist | 2204 Pacific Ave. N., Long Beach, WA 98631 | 2019-11-22 |
| 1427576362 | Susan Amy Goldsmith | Social Worker | 607 Ocean Beach Blvd. N., Long Beach, WA 98631 | 2017-08-30 |
| 1558724302 | Jesse Wityczak | Pharmacist | 101 Bolstad Ave E, Long Beach, WA 98631 | 2016-03-30 |
| 1659618007 | Teresa Mary Fleck | Speech-Language Pathologist | 400 S Washington, Long Beach, WA 98631 | 2013-01-04 |
| 1639400385 | Wendy Liu | Counselor | 2204 Pacififc Avenue N, Long Beach, WA 98631 | 2010-01-20 |
| 1093046088 | Diane L Adams | Counselor | 2204 Pacific Avenue N, Long Beach, WA 98631 | 2010-01-15 |
| 1538498076 | Steven R Fox | Counselor | 22004 Pacific Way N, Long Beach, WA 98631 | 2009-12-11 |
| 1295907137 | Brandon L Adams Md Ps | General Practice | 105 6th St, Long Beach, WA 98631 | 2008-04-01 |
| 1710188263 | Willapa Counseling Center | Clinic/Center | 1107 Pacific Avenue North, Long Beach, WA 98631 | 2007-05-31 |
| Find all providers in zip 98631 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689271454 | Skycare Cuidado Del Cielo LLC | Counselor | 7890 E Spring St Unit 10d, Long Beach, CA 90815-1622 | 2020-10-05 |
| 1376060277 | Rebekkah Dawn Williams | Counselor | 100 East Market Street, Long Beach, CA 90805 | 2017-08-23 |
| 1881110096 | Shafeeullah Hashim Gaines | Counselor | 4335 Altantic Ave, Long Beach, CA 90807 | 2017-08-18 |
| 1215473202 | Nicole Marie Browning | Counselor | 811 Pacific Ave S Ste 7, Long Beach, WA 98631-3544 | 2017-01-13 |
| 1114462637 | Andunett Langhum | Counselor | 4335 Atlantic Blved, Long Beach, CA 90807 | 2016-12-20 |
| 1265980148 | Loretta Marie Jones | Counselor | 707 E Ocean Blvd Apt 817, Long Beach, CA 90802-5176 | 2016-09-20 |
| 1760835094 | Sopheak Tuon | Counselor | 2371 1/2 Lime Ave, Long Beach, CA 90806-3230 | 2016-07-21 |
| 1710350145 | Roshawon Latice Pruitt | Counselor | 735 Cedar Ave Apt 1, Long Beach, CA 90813-4262 | 2015-11-06 |
| 1962878660 | Xaviera Warren | Counselor | 1891 Caspian Ave Apt 1, Long Beach, CA 90810-4205 | 2015-08-17 |
| 1083095244 | Susan Rousseau-reyes | Counselor | 311 E 44th St, Long Beach, CA 90807-1401 | 2015-06-13 |
| Find all providers in LONG BEACH | ||||
| City | LONG BEACH |
| Zip Code | 98631 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.