DR. BRUCE K MCCORMICK


Address: 2210 Line Ave, Suite 104, Shreveport, LA 71104
Phone: 3188657500

DR. BRUCE K MCCORMICK (NPI# 1043327968) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1043327968
Entity Type Individual
Full Name DR. BRUCE K MCCORMICK
Credential PHD
Practice Address 2210 Line Ave
Suite 104
Shreveport
LA 71104
Practice Telephone 3188657500
Practice Fax Number 3188682035
Mailing Telephone 3188657500
Mailing Fax Number 3188682035
Enumeration Date 2006-08-24
Last Update Date 2007-07-16
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 103T00000X Psychologist 631 LA Behavioral Health & Social Service Providers
N 103TC1900X Psychologist
Specialization: Counseling
631 LA Behavioral Health & Social Service Providers
N 103TC2200X Psychologist
Specialization: Clinical Child & Adolescent
631 LA Behavioral Health & Social Service Providers
N 103TF0000X Psychologist
Specialization: Family
631 LA Behavioral Health & Social Service Providers
N 103TS0200X Psychologist
Specialization: School
631 LA Behavioral Health & Social Service Providers
N 106H00000X Marriage & Family Therapist 631 LA Behavioral Health & Social Service Providers
Y 103TP0016X Psychologist
Specialization: Prescribing (Medical)
631MP LA Behavioral Health & Social Service Providers

Office Location

Street Address 2210 LINE AVE
SUITE 104
City SHREVEPORT
State LA
Zip Code 71104

Providers in the same location

NPI Name Taxonomy Address Enumeration
1093776429 W. Harold Brown & Barron J. O'neal (amc) Plastic Surgery 2210 Line Ave, Suite 204, Shreveport, LA 71104-2152 2006-03-28
1760949754 Seeds In Action Community Health Care,inc. Home Health 2210 Line Ave, Shreveport, LA 71104-2152 2019-02-26
1538637632 Valencia Annazette Jones-edwards Counselor 2210 Line Ave, Shreveport, LA 71104-2152 2018-11-06
1932620374 Tierney Charda Strange Counselor 2210 Line Ave, Shreveport, LA 71104-2152 2017-07-06
1255873113 Transitioning Solutions, LLC Community/Behavioral Health 2210 Line Ave, 103, Shreveport, LA 71104-2152 2016-11-09
1306033493 Crews Chiropractic, Inc. Chiropractor 2210 Line Ave, Suite 202, Shreveport, LA 71104-2152 2007-10-02
1467531913 Prn Health Services, PC Specialist 2210 Line Ave, Suite 103, Shreveport, LA 71104-2152 2006-11-03
1194832014 Cheryl S Marsiglia Psychologist 2210 Line Ave, Suite 104, Shreveport, LA 71104 2006-08-24
1184685950 Barron Johns O'neal Plastic Surgery 2210 Line Ave, Suite 204, Shreveport, LA 71104-2152 2006-03-31
1114988995 Wallace Harold Brown II Plastic Surgery 2210 Line Ave, Suite 204, Shreveport, LA 71104-2152 2006-03-31
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1326582263 Dana Jackson Counselor 2425 Youree Drive, Shreveport, LA 71104 2016-12-12
1154772929 Belena Cawthorne Case Manager/Care Coordinator 2040 Southern Ave, Shreveport, LA 71104 2016-06-23
1437505286 Courtney Espenan Counselor 3825 Gilbert Dr Ste 124, Shreveport, LA 71104 2016-05-11
1215390497 Joshua Mitchell Counselor 1106 Dalzell Street, Shreveport, LA 71104 2016-04-04
1699135426 Amy Lutricia Krohn Counselor 1041 Dalzell St, Shreveport, LA 71104 2016-03-07
1225497779 Annie Redding II Counselor 2525 Youree Dr Suite 110, Shreveport, LA 71104 2016-02-12
1891152328 Council On Alcoholism and Drug Abuse of Northwest Louisiana Community/Behavioral Health 2000 Fairfield Ave, Shreveport, LA 71104 2016-01-28
1922465731 Marteze Singleton Case Manager/Care Coordinator 2525 Youree Dr Ste 10, Shreveport, LA 71104 2016-01-25
1891160297 Damara Mora Counselor 2620 Centenary Blvd Bldg3 Ste 312, Shreveport, LA 71104 2015-12-10
1962876250 Chastity Shermaine Graham Counselor 2620 Centenary Blvd Ste 312, Shreveport, LA 71104 2015-11-24
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Taxonomy Information

Taxonomy Code 103TP0016X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Prescribing (Medical)

Taxonomy Definition

Those licensed psychologists who have completed specialized, post-doctoral training in psychopharmacology, passed a national proficiency examination in psychopharmacology, and who are authorized by state statute to prescribe medications, in accordance with their state law and state licensing authority, for the evaluation, diagnosis, management and treatment of mental, nervous, emotional, behavioral, and related disorders.
Notes: Source: Louisiana Academy of Medical Psychologists Note: Some states issue licenses under Medical Psychologist. [1/1/2007: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1710101373 Rebecca Faye Nolan Psychologist 111 Carroll St, Shreveport, LA 71105-4203 2007-04-12

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1790297182 George S. Park, Phd., Mp., A Psychology Corporation Psychologist 2285 Benton Rd Ste 401, Bossier City, LA 71111-7933 2017-10-25
1669887907 John Courtney LLC Psychologist 118 Terra Bella Blvd, Suite 101, Covington, LA 70433-8148 2014-06-25
1730520925 Faw Services, LLC Psychologist 223 Bellingrath Pl, Madisonville, LA 70447-3421 2013-07-16
1134418502 Psychological Health Care of South Louisiana Psychologist 1016 Houma St, Houma, LA 70360-4420 2011-04-06
1922234566 Felicia Ann Whiteman Psychologist 2331 Carey St, Slidell, LA 70458-3627 2009-06-10
1861627465 Lakisha Shantell Williams Psychologist 1409 Kirkman St, Lake Charles, LA 70601-5344 2009-05-26
1013131267 Dr. Maria B. Cruse Apmg Psychologist 604 North Acadia Road, Suite 201, Thibodaux, LA 70301 2007-04-12
1093860371 Maxine Elizabeth Campbell-flint Psychologist 412 N 4th St, Suite 100, Baton Rouge, LA 70802-5523 2007-01-24
1104925932 Williams Consulting Inc. Psychologist 1410 Royal Ave, Monroe, LA 71201-5608 2006-09-21
1043247331 Bryan L Bolwahnn Psychologist 100 Gayven Dr, Ball, LA 71405-4903 2006-06-26
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Competitor

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City SHREVEPORT
Zip Code 71104

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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