MRS. MARILYN J CULLUM (NPI# 1730245465) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730245465 |
| Entity Type | Individual |
| Full Name | MRS. MARILYN J CULLUM |
| Credential | LPC |
| Practice Address |
1742 Falls Blvd. Suite 5 The Logan Center Wynne AR 72396 |
| Mailing Address |
139 County Road 395 Wynne AR 72396 |
| Practice Telephone | 8702089333 |
| Practice Fax Number | 8702089229 |
| Mailing Telephone | 8702385596 |
| Mailing Fax Number | 8702089229 |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
P9807016 | AR | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | BLUE CROSS BLUE SHIELD | 5U425 | 01 |
| Street Address |
1742 FALLS BLVD. SUITE 5 THE LOGAN CENTER |
| City | WYNNE |
| State | AR |
| Zip Code | 72396 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962918813 | David Makool | Occupational Therapy Assistant | 2000 Gogbill Road, Wynne, AR 72396 | 2017-12-14 |
| 1912425554 | Barbara Ann Burgess | Case Manager/Care Coordinator | 661 Addison, Wynne, AR 72396 | 2017-09-05 |
| 1518481308 | Tyler Leigh Shumard | Physical Therapy Assistant | 128 County Road 145, Wynne, AR 72396 | 2017-08-02 |
| 1588957476 | Northeast Arkansas Community Mental Health Center | Counselor | 661 Addison Dr., Wynne, AR 72396 | 2011-05-25 |
| 1417106493 | Katherine Danielle Calhoun | Dietitian, Registered | 1013 Bridges Ave East, Wynne, AR 72396 | 2008-09-15 |
| 1053531319 | George Scott Puryear, Dds, Pa | Dentist | 715 East Eldrdige Avenue, Wynne, AR 72396 | 2007-04-27 |
| 1770655185 | Robert Walton Bassham | Dentist | 669 Addison Drive, Wynne, AR 72396 | 2006-11-14 |
| 1073683827 | George Scott Puryear Jr. | Dentist | 715 E. Eldridge Ave, Wynne, AR 72396 | 2006-11-09 |
| 1194809517 | Richard Keeter Toland | Dentist | 2100 North Killough, Wynne, AR 72396 | 2006-10-24 |
| 1912012337 | Southern Care Inc | Ambulance | 669 N Falls Blv, Wynne, AR 72396 | 2006-08-19 |
| Find all providers in zip 72396 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982904389 | Linda K Ingle, Lpc | Counselor | 222 Mississippi St S Ste A, Wynne, AR 72396-3000 | 2010-11-01 |
| 1023272259 | David M Ray | Counselor | 1792 Falls Blvd N, Ste. 5, Wynne, AR 72396-4092 | 2008-07-16 |
| 1023225992 | Millie F. Lace | Counselor | 202 Commercial Ave E, Wynne, AR 72396-2930 | 2007-05-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841899986 | Cynthia Hrdlichka | Counselor | 2224 E Elaine Ave, Fayetteville, AR 72703-4507 | 2020-10-20 |
| 1568069169 | Blaire Bradbury | Counselor | 1466 N Desoto Pl, Fayetteville, AR 72703-1953 | 2020-10-06 |
| 1063029460 | Onward and Upward Counseling, Pllc | Counselor | 100 North Rockingchair Road, Ste 3, Paragould, AR 72450 | 2020-09-29 |
| 1932712064 | Lavana J. Kindle | Counselor | Victory Church 1283 Us-278 W, Camden, AR 71701-4551 | 2020-08-28 |
| 1275141202 | Leslie Meeker | Counselor | 10068 Buckskin Cir, Rogers, AR 72758-7575 | 2020-07-15 |
| 1710509997 | Dickerson Family Resource Center, LLC | Counselor | 5401 John F. Kennedy Blvd, Suite I Rm 1, North Little Rock, AR 72116 | 2020-05-11 |
| 1114557824 | Elysian Counseling Services Pllc | Counselor | 1024 W Court St Ste C, Paragould, AR 72450-4130 | 2020-01-22 |
| 1588294631 | Puzzle Collaborative | Counselor | 34 W Colt Square Dr Ste 1, Fayetteville, AR 72703-2888 | 2020-01-16 |
| 1487290888 | John Hunter Bramlitt | Counselor | 12320 I-30, Little Rock, AR 72210 | 2019-11-20 |
| 1114562071 | Ariel Brown | Counselor | 10 Remington Dr, Little Rock, AR 72204-8202 | 2019-11-14 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.