Anita McCormack, LCSW
Individual provider Active NPI Clinical Social Worker · Cuba, MO
NPI 1891830477 · NPPES record last updated Apr 27, 2011
Key facts
- NPI
- 1891830477
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 2005031753 (MO)
- Practice address
- 713 S Prairie St
Apt 5
Cuba, MO 65453-1547 - Phone
- (573) 885-0800
- Fax
- (573) 885-1600
- NPI assigned
- Feb 21, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 2005031753 | MO | Yes |
Addresses
Primary practice location
713 S Prairie St
Apt 5
Cuba, MO 65453-1547
Mailing address
713 S Prairie St
Apt 5
Cuba, MO 65453-1547
Phone (573) 885-0800
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MA3202 | Other | MO | MEDICARE PTAN - ORGANIZATION |
| MA3202001 | Other | MO | MEDICARE PTAN - INDIVIDUAL |
| 1891830477 | Medicaid | MO |
Other providers in Cuba, MO
- Bridgette Little
- Hollie Lovell
- Lynch Development, P.C.
- William Albert Lynch Jr.
- Jamie Mabe
- Medley Pharmacy
- Medley Pharmacy Inc
- Mercy Clinic East Communities
- Mercy Clinic Springfield Communities
- Missouri Baptist Hospital of Sullivan
All providers in Cuba, MO · Clinical Social Worker in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 27, 2011. 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.