Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Leisa Annette McCullough, CCC-SLP

Individual provider Speech-Language Pathologist · NPI 1699201715

Leisa Annette McCullough, CCC-SLP is a Speech-Language Pathologist in Jackson, Mississippi. Practices as a sole proprietor. Licensed in Mississippi.

Licensed in
MS
In the registry since
2017
What do these letters mean?
CCC-SLP — Certificate of Clinical Competence in Speech-Language Pathology
A speech-language pathologist certified by ASHA.

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Practice location Address checks out

2500 N State St
Jackson, MS 39216-4500
Phone: (662) 397-8964
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence S3909 (MS)

Record details

NPI number1699201715
Entity typeIndividual (Type 1)
GenderFemale
Credentials CCC-SLP
Sole proprietorYes
NPI enumeratedMay 10, 2017
Last updated in NPPESMay 10, 2017

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