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General NPI Number Information
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NPI Number | 1639774151
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Entity Type | Individual
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Provider Name | KATHARINE ANN MCCORMICK LCSW, MSW
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Gender | Female
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Dates
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Enumeration Date | 12/02/2020
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 7901 4TH ST N STE 300
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City | ST PETERSBURG
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State | FL
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Zip | 33702-4399
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Country | US
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Telephone | 314-252-0699
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Fax |
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Provider Business Mailing Address
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Address Line | 5719 DEVONSHIRE AVE
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City | ST. LOUIS
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State | MO
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Zip | 63109
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Country | US
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Telephone | 314-252-0699
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 2023033287
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 340113668A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 114308
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149028653
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License Number State | IL
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Taxonomy #5
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | TPSW5755
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License Number State | FL
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