CARLY CRISTINE MCCORMACK LADC LPCC NPI 1700478625

NPI Information

NPI: 1700478625
Provider Name: CARLY CRISTINE MCCORMACK, LADC, LPCC
Classification: Counselor - 101YP2500X
Entity Type: Individual

Specialization: Professional

Address:
1250 MOORE LAKE DR E STE 152
FRIDLEY, MN
ZIP 55432
Phone: (612) 389-2332
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Carly Cristine Mccormack, LADC, LPCC is a professional counselor in Fridley, MN. Carly Cristine Mccormack, LADC, LPCC NPI is 1700478625. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1250 MOORE LAKE DR E STE 152
FRIDLEY, MN
ZIP 55432-135
Phone: (612) 389-2332

The enumeration date for this NPI number is 2/11/2021 and was last updated on 7/3/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	305956	MINNESOTA	No
2	101YP2500X	Counselor	Professional	3936	MINNESOTA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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