Active NPI
Wesley Hendrick McCormick, PH.D., M.DIV.
- Psychologist
- Marianna, FL
National Provider Identifier
1598376469
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 2190
- Practice address
- 4970 Highway 90
Marianna, FL 32446-6802 - Phone
- (850) 718-5620
- NPI assigned
- Aug 13, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 2190 | AL | Primary |
Addresses
Primary practice location
4970 Highway 90
Marianna, FL 32446-6802
Mailing address
301 Andrews Avenue
Fort Rucker, AL 36362
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714608000000",
"number": "1598376469",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 ANDREWS AVENUE",
"city": "FORT RUCKER",
"state": "AL",
"postal_code": "36362"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4970 HIGHWAY 90",
"city": "MARIANNA",
"state": "FL",
"postal_code": "324466802",
"telephone_number": "850-718-5620"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCORMICK",
"first_name": "WESLEY",
"middle_name": "HENDRICK",
"name_prefix": "Dr.",
"credential": "PH.D., M.DIV.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-08-13",
"last_updated": "2024-05-02",
"certification_date": "2024-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "AL",
"license": "2190",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marianna, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.