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NPI Code Detail

MEDICARE: MR. PATRICK JAMES MCCULLAGH

MEDICARE: MR. PATRICK JAMES MCCULLAGH
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
1101YA0400XAddiction (Substance Use Disorder) Counselor07787-LNV
2225C00000XRehabilitation Counselor

General Provider Information

NPI Number : 1851794622
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. PATRICK JAMES MCCULLAGH
Provider Business Mailing Address
First Line : 2887 S MARYLAND PKWY
Second Line :
City : LAS VEGAS
State : NV
Zip : 89109-1511
Country : US
Telephone Number : 702-474-4104
Fax Number :
Provider Business Practice Location Address
First Line : 2887 S MARYLAND PKWY
Second Line :
City : LAS VEGAS
State : NV
Zip : 89109-1511
Country : US
Telephone Number : 702-474-4104
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/07/2014
Last Update Date : 08/07/2024

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Directions to “ MR. PATRICK JAMES MCCULLAGH ” Practice Location

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