| Doctor Name: | MR. HARRISON GOODERHAM MCCORMICK |
| NPI Number: | 1578674826 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MSW BCD |
| License Number: | CW000966L |
| Business Practice Address: | 1881 Bitler Hill Road Muncy, PA - 17756 |
| Business Phone Number: | 5705466250 |
| Business Fax Number: | 5705466250 |
| Mailing Address: | 1881 Bitler Hill Road, MUNCY |
| State: | PA |
| Postal Code: | 17756 |
| Phone Number: | 5705466250 |
| Fax Number: | 5705466250 |
| NPI Enumeration Date: | 08/31/2006 |
| NPI Last Update Date: | 01/21/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | CW000966L |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |