Individual
DR. DEANNA MARIE MCCULLOCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
600 CENTRAL AVE STE 302, GREAT FALLS, MT 59401-3141
(406) 201-1485
Mailing address
600 CENTRAL AVE STE 302, GREAT FALLS, MT 59401-3141
(719) 661-7723
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LPC.0012063
CO
101YP2500X
Professional Counselor
Primary
SWP-LCPC-LIC-11614
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0MT0751420
BLUE CROSS-SHIELD OF MONTANA
MT
Enumeration date
02/06/2015
Last updated
03/26/2019
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