# MCCORMACK BEHAVIORAL HEALTH

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255136255
- **Authorized official:** CARLY MCCORMACK MPS, LPCC, LADC (PSYCHOTHERAPIST)
- **Authorized official phone:** (612) 280-9541

## Contact information

- **Practice address:** 12775 SWALLOW ST NW, COON RAPIDS, MN 55448-2587
- **Practice address phone:** (612) 280-9541
- **Mailing address:** PO BOX 43, ANOKA, MN 55303-0043
- **Mailing address phone:** (612) 280-9541

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |

## Other

- **Enumeration date:** 02/14/2025
- **Last updated:** 02/14/2025