Provider Demographics
NPI:1942323019
Name:MCCORMICK, PATRICIA L (LPC)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:L
Last Name:MCCORMICK
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 OFFICE PARK CIR STE 100
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN BRK
Mailing Address - State:AL
Mailing Address - Zip Code:35223-2664
Mailing Address - Country:US
Mailing Address - Phone:205-313-1793
Mailing Address - Fax:
Practice Address - Street 1:1850 SHADES CREST RD
Practice Address - Street 2:
Practice Address - City:VESTAVIA
Practice Address - State:AL
Practice Address - Zip Code:35216-1412
Practice Address - Country:US
Practice Address - Phone:205-979-4670
Practice Address - Fax:205-979-4670
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2518101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional