Provider Demographics
NPI:1598361362
Name:MCCORMICK, CAITLYN MARIE (LCSW)
Entity type:Individual
Prefix:
First Name:CAITLYN
Middle Name:MARIE
Last Name:MCCORMICK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 EAGLE ST RM B002A
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60432-2031
Mailing Address - Country:US
Mailing Address - Phone:224-315-2214
Mailing Address - Fax:
Practice Address - Street 1:1201 EAGLE ST RM B002A
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60432-2031
Practice Address - Country:US
Practice Address - Phone:224-315-2214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-08
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker