Provider Demographics
NPI:1164055430
Name:MCCORMICK, LEE ERIN (LMFT)
Entity type:Individual
Prefix:
First Name:LEE
Middle Name:ERIN
Last Name:MCCORMICK
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8817 E MISSION AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99212-5034
Mailing Address - Country:US
Mailing Address - Phone:509-844-5947
Mailing Address - Fax:
Practice Address - Street 1:8817 E MISSION AVE STE 106
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99212-5034
Practice Address - Country:US
Practice Address - Phone:509-844-5947
Practice Address - Fax:509-954-3343
Is Sole Proprietor?:No
Enumeration Date:2020-02-14
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF61409057106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2153710Medicaid