Provider Demographics
NPI:1578904868
Name:MCCORMICK, MARGARET MARY (RN, BSN, LPC)
Entity type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:MARY
Last Name:MCCORMICK
Suffix:
Gender:
Credentials:RN, BSN, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 N 1ST ST APT 605
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55401-1396
Mailing Address - Country:US
Mailing Address - Phone:303-330-3641
Mailing Address - Fax:
Practice Address - Street 1:400 N 1ST ST APT 605
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55401-1396
Practice Address - Country:US
Practice Address - Phone:303-330-3641
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-15
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014554101Y00000X
COLPC.0013921101YP2500X
CORN-191388163W00000X
MN85631-9163W00000X
MNCC03641101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No163W00000XNursing Service ProvidersRegistered Nurse