Healthcare Provider Details

I. General information

NPI: 1083522213
Provider Name (Legal Business Name): JOSHUA MCCORMICK
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2026
Last Update Date: 08/29/2026
Certification Date: 08/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4975 AUSTIN BLUFFS PKWY
COLORADO SPRINGS CO
80918-5043
US

IV. Provider business mailing address

4975 AUSTIN BLUFFS PKWY
COLORADO SPRINGS CO
80918-5043
US

V. Phone/Fax

Practice location:
  • Phone: 719-330-5425
  • Fax:
Mailing address:
  • Phone: 719-357-9240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: