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NPI Code Detail

MEDICARE: WILLIAM MCCORMACK JR. LMHC

MEDICARE: WILLIAM MCCORMACK JR. 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 Counselor14389FL

General Provider Information

NPI Number : 1548711054
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILLIAM MCCORMACK JR. LMHC
Provider Business Mailing Address
First Line : PO BOX 15442
Second Line :
City : CLEARWATER
State : FL
Zip : 33766-5442
Country : US
Telephone Number : 727-385-9902
Fax Number :
Provider Business Practice Location Address
First Line : 2430 ESTANCIA BLVD STE 106
Second Line :
City : CLEARWATER
State : FL
Zip : 33761-2607
Country : US
Telephone Number : 727-275-2684
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/19/2016
Last Update Date : 05/29/2019

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Directions to “ WILLIAM MCCORMACK JR. LMHC” Practice Location

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