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General NPI Number Information
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NPI Number | 1356861488
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Entity Type | Individual
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Provider Name | BRYCE MCCULLOCH LMFT
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Gender | Male
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Dates
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Enumeration Date | 06/20/2017
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Last Update Date | 02/10/2025
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Provider Practice Location Address
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Address Line | 260 E 11TH AVE
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City | EUGENE
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State | OR
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Zip | 97401-3247
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Country | US
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Telephone | 541-484-4428
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Fax |
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Provider Business Mailing Address
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Address Line | 1709 LEGION RD STE 219
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City | CHAPEL HILL
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State | NC
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Zip | 27517-2374
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Country | US
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Telephone | 336-264-4176
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 00983
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License Number State | NC
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