Provider Demographics
NPI:1669101028
Name:MCCULLEN, ERIN
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:MCCULLEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 PECAN CT
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:NC
Mailing Address - Zip Code:28443-8037
Mailing Address - Country:US
Mailing Address - Phone:910-622-5021
Mailing Address - Fax:
Practice Address - Street 1:2424 COMMERCE RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-7505
Practice Address - Country:US
Practice Address - Phone:252-557-0444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-09
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional