Mary Beth McCormick, LMHC
Individual provider Active NPI Mental Health Counselor · Derby, NY
NPI 1417487448 · NPPES record last updated May 16, 2019
Key facts
- NPI
- 1417487448
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 006451 (NY)
- Practice address
- 6722 Erie Rd
Derby, NY 14047-9670 - Phone
- (716) 947-5025
- NPI assigned
- Jun 13, 2017
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 006451 | NY | MD | Podiatrist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 006451 | NY | Yes |
Addresses
Primary practice location
6722 Erie Rd
Derby, NY 14047-9670
Mailing address
713 Lake St
Angola, NY 14006-9630
Phone (716) 725-9086
Other practice location 1
229 Main St
Hamburg, NY 14075-4915
Phone (716) 725-9086
Other providers in Derby, NY
- Debra Sue Longbine
- Laura Ann Majkut
- Holly Kathryn Mangus
- Amy Beth Martinez
- Christopher J McCann
- Madison Elizabeth McDonagh
- Peter Samuel McQuiller
- Alexandra Mott
- John M Mulawka III
- Mary Katherine Nolan-Eaton
All providers in Derby, NY · Mental Health Counselor in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 16, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.