Provider Demographics
NPI:1033651112
Name:MCCORMICK, RILEY MORGAN (LMHC)
Entity Type:Individual
Prefix:MS
First Name:RILEY
Middle Name:MORGAN
Last Name:MCCORMICK
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4502 51ST AVE SW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98116-4031
Mailing Address - Country:US
Mailing Address - Phone:360-607-4221
Mailing Address - Fax:
Practice Address - Street 1:4502 51ST AVE SW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98116-4031
Practice Address - Country:US
Practice Address - Phone:360-607-4221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-07
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60691587101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health