Provider Demographics
NPI:1962412825
Name:MCCORMICK, CORTNEY L (LPA)
Entity type:Individual
Prefix:
First Name:CORTNEY
Middle Name:L
Last Name:MCCORMICK
Suffix:
Gender:F
Credentials:LPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 BRENNER AVE
Mailing Address - Street 2:11M-2
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28144-2515
Mailing Address - Country:US
Mailing Address - Phone:704-638-9000
Mailing Address - Fax:704-638-3898
Practice Address - Street 1:1601 BRENNER AVE
Practice Address - Street 2:11M-2
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-2515
Practice Address - Country:US
Practice Address - Phone:704-638-9000
Practice Address - Fax:704-638-3898
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2009-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2582101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor