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NPI Code Detail

MEDICARE: WESLEY THOMAS MCCULLEY LCSW-C

MEDICARE: WESLEY THOMAS MCCULLEY LCSW-C
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
11041C0700XClinical Social Worker26890MD

General Provider Information

NPI Number : 1033919808
Entity Type Code : Individual
Provider Name (Legal Business Name) : WESLEY THOMAS MCCULLEY LCSW-C
Provider Business Mailing Address
First Line : 427 E PATRICK ST
Second Line :
City : FREDERICK
State : MD
Zip : 21701-5777
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 427 E PATRICK ST
Second Line :
City : FREDERICK
State : MD
Zip : 21701-5777
Country : US
Telephone Number : 301-662-7003
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2025
Last Update Date : 03/19/2025

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Directions to “ WESLEY THOMAS MCCULLEY LCSW-C” Practice Location

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