Healthcare Provider Details

I. General information

NPI: 1659076156
Provider Name (Legal Business Name): DAVID LEWIS MCCORD LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2023
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4700 ENTERPRISE WAY
MODESTO CA
95356
US

IV. Provider business mailing address

2930 GEER RD # 187
TURLOCK CA
95382-1142
US

V. Phone/Fax

Practice location:
  • Phone: 185-526-8409
  • Fax:
Mailing address:
  • Phone: 209-585-3509
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT155595
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberAPCC13828
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: