Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mrs. Ketevan Gagnidze-McCormick, LMHC

Individual provider Mental Health Counselor · NPI 1356661037

Mrs. Ketevan Gagnidze-McCormick, LMHC is a Mental Health Counselor in Newburgh, New York. Qualified in 1985, 41 years ago. Practices with Wendy Keller, LCSW, LLC, an 11-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New Jersey and New York.

Years since qualifying
41
Licensed in
NJ, NY
In the registry since
2010
Specialties on file
3
What do these letters mean?
LMHC — Licensed Mental Health Counselor
A licensed mental health counsellor; the title used in Florida, New York and Washington among others.

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Practice location Address checks out

10 Bruce St
Newburgh, NY 12550-6602
Phone: (845) 561-7284
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence 003123 (NY)
Professional Counselor Taxonomy 101YP2500X · Licence 37PC00314800 (NJ)
Social Worker Taxonomy 104100000X · Licence 44SW05190800 (NJ)

Record details

NPI number1356661037
Entity typeIndividual (Type 1)
GenderFemale
Credentials LMHC
Sole proprietorYes
NPI enumeratedJune 4, 2010
Last updated in NPPESJune 4, 2010

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 1985 (41 years in practice)
Group practice Wendy Keller, Lcsw, Llc — 11 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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