Provider Demographics
NPI:1235816000
Name:MCCULLOUGH, CATHERINE M (LPC)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:M
Last Name:MCCULLOUGH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17365 TWINOAKS PL
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:VA
Mailing Address - Zip Code:20158-3162
Mailing Address - Country:US
Mailing Address - Phone:215-287-0829
Mailing Address - Fax:
Practice Address - Street 1:42035 LOUDOUN CENTER PL
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20175-8954
Practice Address - Country:US
Practice Address - Phone:571-233-0407
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-03
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701012361101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health