Provider Demographics
NPI:1801941661
Name:MCORMICK, MARY ASHLEY (LCSW)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:ASHLEY
Last Name:MCORMICK
Suffix:
Gender:F
Credentials:LCSW
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Mailing Address - Street 1:9003 WESTON PKWY
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-2201
Mailing Address - Country:US
Mailing Address - Phone:919-677-1459
Mailing Address - Fax:919-677-1489
Practice Address - Street 1:9003 WESTON PKWY
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-2201
Practice Address - Country:US
Practice Address - Phone:919-677-1459
Practice Address - Fax:919-677-1489
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2012-04-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NCC0049891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1396FOtherBCBSNC
NC2241848OtherCIGNA
NC6003546Medicaid
NY810325000OtherMAGELLAN