Healthcare Provider Details

I. General information

NPI: 1922045244
Provider Name (Legal Business Name): NAOMI BETH MCCORMICK PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 04/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2717 MINNETONKA DR CLINICAL HEALTH PSYCHOLOGISTS, PLC
CEDAR FALLS IA
50613-1531
US

IV. Provider business mailing address

PO BOX 1066 CLINICAL HEALTH PSYCHOLOGISTS, PLC
CEDAR FALLS IA
50613-0048
US

V. Phone/Fax

Practice location:
  • Phone: 319-240-7456
  • Fax:
Mailing address:
  • Phone: 319-240-7456
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number000809
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number00809
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License Number000809
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: