Provider Demographics
NPI:1316516594
Name:MCCORMICK, AARON (LCSW)
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:MCCORMICK
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 E 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-1406
Mailing Address - Country:US
Mailing Address - Phone:509-462-2500
Mailing Address - Fax:509-462-2503
Practice Address - Street 1:504 E 2ND AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-1406
Practice Address - Country:US
Practice Address - Phone:509-462-2500
Practice Address - Fax:509-462-2503
Is Sole Proprietor?:No
Enumeration Date:2021-06-22
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1678811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
1124078969OtherDEPT OF VETERAN'S AFFAIRS