NPIMap

Organization Active NPI

Family Psychology and Counseling

  • Prescribing (Medical) Psychologist
  • Shreveport, LA
National Provider Identifier
1730446410
Registry record updated Apr 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prescribing (Medical) PsychologistTaxonomy code 103TP0016X
Legal business name
FAMILY PSYCHOLOGY AND COUNSELING
Practice address
1513 Line Ave
Suite 305
Shreveport, LA 71101-4621
Phone
(318) 865-7500
Fax
(318) 868-2035
NPI assigned
Apr 18, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2012

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

Authorized official

Name
Dr. Bruce KQ McCormick, PH.D.NPI 1043327968
Title
Medical Psychologist/Owner
Phone
(318) 865-7500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X
Prescribing (Medical) PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TP0016X Primary

Addresses

Primary practice location

1513 Line Ave
Suite 305
Shreveport, LA 71101-4621

Mailing address

1513 Line Ave
Suite 305
Shreveport, LA 71101-4621
Phone (318) 865-7500

Other names 1

  • Bruce McCormick Ph.D. Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1334707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334707200000",
    "number": "1730446410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1513 LINE AVE",
            "address_2": "SUITE 305",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014621",
            "telephone_number": "318-865-7500",
            "fax_number": "318-868-2035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1513 LINE AVE",
            "address_2": "SUITE 305",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014621",
            "telephone_number": "318-865-7500",
            "fax_number": "318-868-2035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY PSYCHOLOGY AND COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-18",
        "last_updated": "2012-04-18",
        "status": "A",
        "authorized_official_last_name": "MCCORMICK",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "KQ",
        "authorized_official_title_or_position": "MEDICAL PSYCHOLOGIST/OWNER",
        "authorized_official_telephone_number": "318-865-7500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TP0016X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bruce McCormick Ph.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Shreveport, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2012; 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.