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General NPI Number Information
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NPI Number | 1124250881
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Entity Type | Individual
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Provider Name | JAMES W MCCORMICK III MA
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Gender | Male
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Dates
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Enumeration Date | 08/13/2009
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 109 S 32ND ST
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City | BILLINGS
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State | MT
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Zip | 59101-3910
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Country | US
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Telephone | 314-250-9540
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3381
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City | BILLINGS
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State | MT
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Zip | 59103-3381
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Country | US
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Telephone | 314-250-9540
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | BBH-LCPC-LIC-13151
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 2009024007
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License Number State | MO
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