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Individual

DR. CANDACE A MCCULLOUGH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHD, LCPC, ACS, DCC

Contact information

Practice address
11110 WHISPERWOOD LN, N BETHESDA, MD 20852-3668
(301) 493-6044
Mailing address
11110 WHISPERWOOD LN, N BETHESDA, MD 20852-3668
(301) 493-6044

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LC 0662
MD
101YM0800X
Mental Health Counselor
PRC13760
DC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4093585 00
MD
01
J4880001
BC BS
MD
Enumeration date
05/17/2007
Last updated
03/25/2011
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