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Individual
KECIA LEE MCCULLOUGH
Active
Individual
KECIA LEE MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CASAC MASTERS, LMSW
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
28786
NY
1041C0700X
Clinical Social Worker
Primary
097126
NY
Other
Enumeration date
09/30/2014
Last updated
02/29/2024
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