Individual
MR. GARDNER MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
3301 RICHMOND HWY # 1192, ALEXANDRIA, VA 22305-3044
(571) 596-7864
(833) 542-3318
Mailing address
3301 RICHMOND HWY # 1192, ALEXANDRIA, VA 22305-3044
(443) 417-7463
(833) 542-3318
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
25268
MD
Other
Enumeration date
07/14/2020
Last updated
12/17/2025
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