Bryan McCormick, LPCC, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH12321 Issued in FL

Practice address

1801 American Blvd E
Bloomington, MN 55425-1232

Phone

(612) 767-7222

NPI assigned

May 14, 2015

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Fraser Child and Family Center

  • Adolescent and Children Mental Health Clinic/Center
  • Minneapolis, MN
  • NPI 1609922194
  Medicare reassignment NPD
• Fraser

  • Rehabilitation Clinic/Center
  • Richfield, MN
  • NPI 1063568574
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1431561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641168000000",
    "number": "1518345107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 AMERICAN BLVD E",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554251232",
            "telephone_number": "612-767-7222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 AMERICAN BLVD E",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554251232",
            "telephone_number": "612-767-7222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORMICK",
        "first_name": "BRYAN",
        "name_prefix": "Mr.",
        "credential": "LPCC, LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-05-14",
        "last_updated": "2022-01-03",
        "certification_date": "2022-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH12321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy J. McCarthy, PH.D.
• Travis Gene McCathie, DC, M.ED., ATC
• Macy McClain
• Abigail Lauren McConeghey
• Anna McCormick
• Maria McCoshen-Skrivseth, PA-C
• Christopher McCoy, MD
• Brookelynn McCumber, MS, BCBA, LBA
• Jessica McDonald, PA-C
• Lindsey E McDonald

• Mental Health Counselor in Bloomington, MN
• Providers in Bloomington, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.