Provider Demographics
NPI:1104951706
Name:MCCORD, JOHN J (LCSW)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:J
Last Name:MCCORD
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:MR
Other - First Name:JOHN
Other - Middle Name:J
Other - Last Name:MCCORD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:45 MERRIMACK ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01852-1729
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:45 MERRIMACK ST
Practice Address - Street 2:SUITE 200
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852-1729
Practice Address - Country:US
Practice Address - Phone:978-459-2306
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2101591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical