Provider Demographics
NPI:1710458153
Name:MCCULLOUGH, YOSHICA LASHEA (LCPC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:YOSHICA
Middle Name:LASHEA
Last Name:MCCULLOUGH
Suffix:
Gender:F
Credentials:LCPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:938 E SWAN CREEK RD # 220
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-5250
Mailing Address - Country:US
Mailing Address - Phone:402-493-9200
Mailing Address - Fax:240-493-9205
Practice Address - Street 1:407 RIVER BEND RD
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744-5540
Practice Address - Country:US
Practice Address - Phone:571-359-3969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-11
Last Update Date:2023-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC10400101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional