MEDICARE: LAWRENCE CULL JR. PSYD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	71-006421	IL

General Provider Information

NPI Number	:	1225004633
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAWRENCE CULL JR. PSYD

Provider Business Mailing Address
First Line	:	310 OVERLOOK RD STE B
Second Line	:
City	:	ASHEVILLE
State	:	NC
Zip	:	28803-3319
Country	:	US
Telephone Number	:	828-438-5788
Fax Number	:	828-333-5360

Provider Business Practice Location Address
First Line	:	57 HOWARD GAP RD
Second Line	:
City	:	FLETCHER
State	:	NC
Zip	:	28732-9560
Country	:	US
Telephone Number	:	828-483-4330
Fax Number	:	828-483-5417

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/24/2006
Last Update Date	:	03/11/2020

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