Provider Demographics
NPI:1174686554
Name:MCCORMICK, JANET L (LISW)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:L
Last Name:MCCORMICK
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 341
Mailing Address - Street 2:
Mailing Address - City:BELLEFONTAINE
Mailing Address - State:OH
Mailing Address - Zip Code:43311-0341
Mailing Address - Country:US
Mailing Address - Phone:937-592-9545
Mailing Address - Fax:937-592-9790
Practice Address - Street 1:1020 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BELLEFONTAINE
Practice Address - State:OH
Practice Address - Zip Code:43311-1617
Practice Address - Country:US
Practice Address - Phone:937-592-9545
Practice Address - Fax:937-592-9790
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker