Pamela McCormick, MA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

IMH20316 Issued in FL

Practice address

43 Knight Boxx Rd Ste 100
Orange Park, FL 32065-7395

Phone

(904) 379-8675

NPI assigned

Feb 14, 2022

Last updated

Feb 14, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

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

• River's Edge Counseling, PLLC

  • Mental Health Counselor
  • Jacksonville, FL
  • NPI 1548958168
  NPD (past)

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

{
    "created_epoch": "1644796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644796800000",
    "number": "1669127122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 KNIGHT BOXX RD STE 100",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320657395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 KNIGHT BOXX RD STE 100",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320657395",
            "telephone_number": "904-379-8675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORMICK",
        "first_name": "PAMELA",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-14",
        "last_updated": "2022-02-14",
        "certification_date": "2022-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH20316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pam.mccormick@riversedgeorangepark.com",
            "affiliation": "Y",
            "affiliationName": "River's Edge Counseling, PLLC",
            "address_1": "43 Knight Boxx Rd Ste 100",
            "city": "Orange Park",
            "state": "FL",
            "country_code": "US",
            "postal_code": "320657395",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michael Thomas McClure, DMD
• Kelly McComiskey, ATC
• Dee Alexandra McConnell, NP
• Erica McConnell
• Lyndsey McCool, L.M.T.
• Eugene H McCoskey, D.O.
• Melissa McCrary
• Jennifer Ann McCrea, ARNP
• Barry G McCullough, PA
• Donna Wilgus McDaniel, RDN

• Mental Health Counselor in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.