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NPI Code Detail

MEDICARE: TREVOR MCCORKLE LMHC

MEDICARE: TREVOR MCCORKLE LMHC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor39006047AIN

General Provider Information

NPI Number : 1194655274
Entity Type Code : Individual
Provider Name (Legal Business Name) : TREVOR MCCORKLE LMHC
Provider Business Mailing Address
First Line : 2700 LAFAYETTE ST STE 110
Second Line :
City : FORT WAYNE
State : IN
Zip : 46806-1100
Country : US
Telephone Number : 260-266-0780
Fax Number : 260-266-0785
Provider Business Practice Location Address
First Line : 404 E WASHINGTON BLVD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46802-3210
Country : US
Telephone Number : 260-266-0780
Fax Number : 260-266-0785
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2026
Last Update Date : 05/21/2026

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Directions to “ TREVOR MCCORKLE LMHC” Practice Location

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