Individual
MS. ELAINE KIMBERLY MCCULLOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
2780 S JONES BLVD STE 100A, LAS VEGAS, NV 89146-5625
(702) 820-3061
Mailing address
3018 SUNSET HARBOR CT, NORTH LAS VEGAS, NV 89031-0555
(702) 249-1888
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1148
NV
101YM0800X
Mental Health Counselor
PH1535
MS
101YP2500X
Professional Counselor
1148
NV
101YP2500X
Professional Counselor
3374
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1770767352
—
NV
05
—
1770767352
—
TN
Enumeration date
12/19/2007
Last updated
02/02/2021
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