MEDICARE: SHAYLA MCCORMICK

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	OH
2	171M00000X	Case Manager/Care Coordinator	OH
3	101YM0800X	Mental Health Counselor	OH

General Provider Information

NPI Number	:	1982431649
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAYLA MCCORMICK

Provider Business Mailing Address
First Line	:	1856 CEDAR HILL RD
Second Line	:
City	:	LANCASTER
State	:	OH
Zip	:	43130-4178
Country	:	US
Telephone Number	:	740-796-8835
Fax Number	:

Provider Business Practice Location Address
First Line	:	1856 CEDAR HILL RD
Second Line	:
City	:	LANCASTER
State	:	OH
Zip	:	43130-4178
Country	:	US
Telephone Number	:	740-796-8835
Fax Number	:

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

Provider Enumeration Date	:	09/17/2024
Last Update Date	:	04/06/2026

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