KELLY BURNS MCCORMACK (NPI# 1376064964) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376064964 |
| Entity Type | Individual |
| Full Name | KELLY BURNS MCCORMACK |
| Credential | ATR |
| Practice Address |
435 W 4th St Williamsport PA 17701-6001 |
| Mailing Address |
15 Trump Rd Danville PA 17821-9375 |
| Practice Telephone | 5703227873 |
| Mailing Telephone | 5704125106 |
| Enumeration Date | 2017-07-05 |
| Last Update Date | 2017-07-05 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | Behavioral Health & Social Service Providers | ||
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| N | 225800000X | Recreation Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518261577 | Kelly Mccormack | Nurse Practitioner | 503 North 21st St., Camp Hill, PA 17011-8531 | 2011-01-06 |
| Street Address |
435 W 4TH ST |
| City | WILLIAMSPORT |
| State | PA |
| Zip Code | 17701-6001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578528865 | Ronald L. Pope | Family Medicine | 435 W 4th St, Williamsport, PA 17701-6001 | 2006-04-19 |
| 1619508421 | Kathryn Mccarty-welch | Counselor | 435 W 4th St, Williamsport, PA 17701-6001 | 2020-01-30 |
| 1881239390 | Christine Manenkoff | Case Manager/Care Coordinator | 435 W 4th St, Williamsport, PA 17701-6001 | 2019-11-08 |
| 1205487154 | Amanda Hassler | Counselor | 435 W 4th St, Williamsport, PA 17701-6001 | 2019-09-23 |
| 1871051326 | Elizabeth A Blanton | Counselor | 435 W 4th St, Williamsport, PA 17701-6001 | 2019-03-04 |
| 1891259602 | Sara Vanbuskirk | Counselor | 435 W 4th St, Williamsport, PA 17701-6001 | 2019-01-25 |
| 1124582382 | Scott Carpenter | Counselor | 435 W 4th St, Williamsport, PA 17701-6001 | 2019-01-22 |
| 1275028672 | Morgan Churchill | Counselor | 435 W 4th St, Williamsport, PA 17701-6001 | 2018-06-27 |
| 1023539970 | Tonya Rene Anderson | Counselor | 435 W 4th St, Williamsport, PA 17701-6001 | 2017-06-30 |
| 1881141331 | Christina Lynn Robidoux | Counselor | 435 W 4th St, Williamsport, PA 17701-6001 | 2016-09-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184267809 | Charlene Angella Pitter | Nurse Practitioner | 170 Warren Ave, Williamsport, PA 17701 | 2019-10-25 |
| 1396395299 | Susan E Fetzer | Occupational Therapy Assistant | Upmc Susquehanna,625 West Edwin Street, Williamsport, PA 17701 | 2019-09-13 |
| 1184280984 | Craig Andrew Tuller | Student in an Organized Health Care Education/Training Program | Williamsport Family Medicine Residency, 740 High Street, Suite 4001, Williamsport, PA 17701 | 2019-05-16 |
| 1760048045 | Michael Harvey | Student in an Organized Health Care Education/Training Program | 740 High St. Suite 4001, Williamsport, PA 17701 | 2019-05-13 |
| 1275196008 | Olivia Fladmark | Student in an Organized Health Care Education/Training Program | Williamsport Family Medicine Residency 740 High St, Suite 4001, Williamsport, PA 17701 | 2019-04-17 |
| 1528551231 | Mark Hampton Chiropractic Inc. | Durable Medical Equipment & Medical Supplies | 1111 East 3rd Street, Williamsport, PA 17701 | 2018-06-08 |
| 1548710882 | Central Pennsylvania Rehabilitation Medicine, Inc | Physical Medicine & Rehabilitation | 460 River Ave Ste 1, Williamsport, PA 17701 | 2016-10-11 |
| 1376096784 | Christine Kessler | Physician Assistant | One College Ave, Penna. College of Tech, Pa Program Dif 123, Williamsport, PA 17701 | 2016-08-02 |
| 1629440276 | Matthew Ray Rebuck | Specialist/Technologist | 220 N Reach Rd, Williamsport, PA 17701 | 2015-10-22 |
| 1508237223 | Neihl Williamson | Physician Assistant | 1205 Grampian Blvd Ste 3c, Williamsport, PA 17701 | 2015-10-08 |
| Find all providers in zip 17701 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548887789 | Jamie Plocinski Lcsw | Counselor | 953 Market St, Williamsport, PA 17701-3448 | 2020-07-04 |
| 1881225118 | Kayla Marie Schuster | Counselor | 10806 Vetra Ln, Williamsport, MD 21795-1453 | 2020-01-27 |
| 1700437977 | Ashley S Nicholas | Counselor | 360 Market St Ste 201, Williamsport, PA 17701-6332 | 2019-09-27 |
| 1265943468 | Joseph Hartley Wells | Counselor | 520 W 4th St Ste 2b, Williamsport, PA 17701-6038 | 2017-10-16 |
| 1679940266 | Lorrie Taylor | Counselor | 912 Diamond St, Williamsport, PA 17701-4332 | 2015-08-31 |
| 1104051671 | Jessie S. Hartman | Counselor | Diakon Family Life Services, 435 W. Fourth Street, Williamsport, PA 17701 | 2009-05-27 |
| 1679187348 | Dana Lockridge | Counselor | 1000 Commerce Park Dr Ste 110, Williamsport, PA 17701-5475 | 2020-09-01 |
| 1619508421 | Kathryn Mccarty-welch | Counselor | 435 W 4th St, Williamsport, PA 17701-6001 | 2020-01-30 |
| 1457901647 | Kayla Baker | Counselor | 1000 Commerce Park Dr Ste 110, Williamsport, PA 17701-5475 | 2019-09-19 |
| 1568012243 | Christopher Wysocki | Counselor | 1000 Commerce Park Dr Ste 110, Williamsport, PA 17701-5475 | 2019-09-16 |
| Find all providers in WILLIAMSPORT | ||||
| City | WILLIAMSPORT |
| Zip Code | 17701 |
Please comment or provide details below to improve the information on KELLY BURNS MCCORMACK.
| 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.