Individual
KENNETH MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LADC, LCPC
Contact information
Practice address
52 WATER ST, SUITE 2, HALLOWELL, ME 04347
(207) 430-3777
(207) 621-4020
Mailing address
52 WATER ST, SUITE 2, HALLOWELL, ME 04347
(207) 430-3777
(207) 621-4020
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LC197
ME
101YM0800X
Mental Health Counselor
Primary
CC1102
ME
Other
Enumeration date
02/03/2012
Last updated
12/07/2015
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