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).
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 |
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 |
Street Address |
2210 LINE AVE SUITE 104 |
City | SHREVEPORT |
State | LA |
Zip Code | 71104 |
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 |
Find all providers in the same location |
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 |
Find all providers in zip 71104 |
Taxonomy Code | 103TP0016X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Psychologist |
Specialization | Prescribing (Medical) |
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] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1710101373 | Rebecca Faye Nolan | Psychologist | 111 Carroll St, Shreveport, LA 71105-4203 | 2007-04-12 |
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 |
Find all providers with the same taxonomy |
City | SHREVEPORT |
Zip Code | 71104 |
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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.