Individual ProviderMary McculloughCounselorBehavioral Health & Social Service ProvidersPractice Address11415 NE 128th St Ste 100, Kirkland, WA 98034-6314(206) 570-6372PECOS EnrollmentBased on the most recent information from CMS, provider Mary Mccullough does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1922216837Provider TypeIndividualFull NameMccullough, MaryCredentialMA LMHCGenderFemaleSole ProprietorYesEnumeration Date5/21/2007Last Updated7/8/2007Contact InformationPractice LocationPractice Address11415 NE 128th St Ste 100, Kirkland, WA 98034-6314Phone(206) 570-6372FaxUnlisted FaxMailing LocationMailing Address11415 NE 128th St Ste 100, Kirkland, WA 98034-6314Phone(206) 570-6372FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerWashington