Healthcare Provider Details

I. General information

NPI: 1457526816
Provider Name (Legal Business Name): LYNN M. MCCORMICK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2008
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49 SCHOOL ST. HCRS
HARTFORD VT
05047-0709
US

IV. Provider business mailing address

390 RIVER ST HCRS
SPRINGFIELD VT
05156-2226
US

V. Phone/Fax

Practice location:
  • Phone: 802-295-3031
  • Fax:
Mailing address:
  • Phone: 802-886-4500
  • Fax: 802-886-4520

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number042.0012698
License Number StateVT
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number15258
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: