Individual
KEYONNA SHAWNTEL MCCULLOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1075 WASHINGTON ST, EUGENE, OR 97401-4606
(541) 321-2278
(541) 246-8826
Mailing address
5560 A ST, SPRINGFIELD, OR 97478-6291
(541) 731-4158
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
A3534
OR
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
L18471
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5006614690
—
OR
Enumeration date
03/24/2010
Last updated
07/23/2026
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