MEDICARE: CAITLYN MCCORMACK

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
1	1041C0700X	Clinical Social Worker	44SC06478300	NJ
2	104100000X	Social Worker

General Provider Information

NPI Number	:	1467282038
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAITLYN MCCORMACK

Provider Business Mailing Address
First Line	:	121 CHANLON RD
Second Line	:
City	:	NEW PROVIDENCE
State	:	NJ
Zip	:	07974-1543
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	550 DORIAN RD
Second Line	:
City	:	WESTFIELD
State	:	NJ
Zip	:	07090-3302
Country	:	US
Telephone Number	:	908-789-4500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/07/2024
Last Update Date	:	02/02/2026

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Directions to “ CAITLYN MCCORMACK ” Practice Location

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