Provider Demographics
NPI:1497982961
Name:WILSON-MCCORMACK, CARMILYA (PHD)
Entity type:Individual
Prefix:
First Name:CARMILYA
Middle Name:
Last Name:WILSON-MCCORMACK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:CARMILYA
Other - Middle Name:
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:316 W SAINT LOUIS ST
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-4406
Mailing Address - Country:US
Mailing Address - Phone:501-436-9044
Mailing Address - Fax:
Practice Address - Street 1:316 W SAINT LOUIS ST
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-4406
Practice Address - Country:US
Practice Address - Phone:501-321-8200
Practice Address - Fax:501-321-8202
Is Sole Proprietor?:No
Enumeration Date:2009-06-11
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2022555103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist