Provider Demographics
NPI:1619211083
Name:MARTIN-MCCORMICK, LYNDA MARIE
Entity Type:Individual
Prefix:
First Name:LYNDA
Middle Name:MARIE
Last Name:MARTIN-MCCORMICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5842 SHERIER PL NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-5322
Mailing Address - Country:US
Mailing Address - Phone:202-363-2863
Mailing Address - Fax:
Practice Address - Street 1:4201 CONNECTICUT AVE NW
Practice Address - Street 2:SUITE 300
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-1158
Practice Address - Country:US
Practice Address - Phone:202-624-0010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-25
Last Update Date:2012-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral