Provider Demographics
NPI:1922534197
Name:PRICHARD MCCORMICK, JOSEPHINE LOUISE
Entity Type:Individual
Prefix:MRS
First Name:JOSEPHINE
Middle Name:LOUISE
Last Name:PRICHARD 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 1:1 CRISIS CENTER PLAZA
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-1238
Mailing Address - Country:US
Mailing Address - Phone:813-264-9955
Mailing Address - Fax:813-868-3996
Practice Address - Street 1:1 CRISIS CENTER PLAZA
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-1238
Practice Address - Country:US
Practice Address - Phone:813-264-9955
Practice Address - Fax:813-868-3996
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-10
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical