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

MS. Mary Angela Macculloch, LCSW

Individual provider Clinical Social Worker · NPI 1023369675

MS. Mary Angela Macculloch, LCSW is a Clinical Social Worker in Fort Drum, New York. Licensed in New York. Registered with an NPI since 2012.

Licensed in
NY
In the registry since
2012
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

See every abbreviation used in this directory →

Practice location Address checks out

11050 Mount Belvedere Blvd
Fort Drum, NY 13602-5438
Phone: (315) 772-7624
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 075757-1 (NY)

Record details

NPI number1023369675
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorNo
NPI enumeratedSeptember 23, 2012
Last updated in NPPESNovember 22, 2024
Certification dateNovember 21, 2024

Other providers in Fort Drum