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General NPI Number Information
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NPI Number | 1376951640
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Entity Type | Organization
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Legal Business Name | KIRSTEN A. CULLER,LCSW-C, LLC
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Dates
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Enumeration Date | 07/30/2014
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Last Update Date | 01/31/2017
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Provider Practice Location Address
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Address Line | 111 W MAIN ST SUITE E
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City | SALISBURY
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State | MD
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Zip | 21801-4973
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Country | US
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Telephone | 443-737-4114
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Fax | 443-736-7982
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Provider Business Mailing Address
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Address Line | 111 W MAIN ST SUITE E
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City | SALISBURY
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State | MD
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Zip | 21801-4973
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Country | US
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Telephone | 443-736-4114
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Fax | 443-736-7982
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Authorized Official
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Title or Position | OWNER
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Name | MS. KIRSTEN ALLEN CULLER
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Credential | LCSW-C, ACSW
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Telephone | 443-736-4114
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 12642
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License Number State | MD
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