Provider Demographics
NPI:1922087634
Name:CULLER, DUANE D (LISW, CGC)
Entity Type:Individual
Prefix:MR
First Name:DUANE
Middle Name:D
Last Name:CULLER
Suffix:
Gender:M
Credentials:LISW, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16065 GLYNN RD
Mailing Address - Street 2:
Mailing Address - City:E CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44112-3534
Mailing Address - Country:US
Mailing Address - Phone:216-761-4861
Mailing Address - Fax:216-844-7497
Practice Address - Street 1:20600 CHAGRIN BLVD
Practice Address - Street 2:SUITE 7500
Practice Address - City:SHAKER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44122-5327
Practice Address - Country:US
Practice Address - Phone:216-761-4861
Practice Address - Fax:216-844-7497
Is Sole Proprietor?:No
Enumeration Date:2006-01-11
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
170300000X
OHI.12015911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No170300000XOther Service ProvidersGenetic Counselor, MS