Provider Demographics
NPI:1124250881
Name:MCCORMICK, JAMES W III (MA)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:W
Last Name:MCCORMICK
Suffix:III
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3381
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59103-3381
Mailing Address - Country:US
Mailing Address - Phone:314-250-9540
Mailing Address - Fax:
Practice Address - Street 1:109 S 32ND ST
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-3910
Practice Address - Country:US
Practice Address - Phone:314-250-9540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCPC-LIC-13151101YM0800X
MO2009024007101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health