Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kelley D McCullough

Individual provider Clinical Social Worker · NPI 1104558048

Kelley D McCullough is a Clinical Social Worker in Los Angeles, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2022

Practice location Address checks out

3862 S Redondo Blvd
Los Angeles, CA 90008-1113
Phone: (310) 350-4350
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence LCSW107966 (CA)

Record details

NPI number1104558048
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJune 29, 2022
Last updated in NPPESJune 29, 2022
Certification dateJune 22, 2022

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