MEDICARE: JENNIFER MCCARTY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician
2	103K00000X	Behavior Analyst	1-22-62614	GA

General Provider Information

NPI Number	:	1285291104
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER MCCARTY

Provider Business Mailing Address
First Line	:	4604 BOSTON IVY DR
Second Line	:
City	:	FORTSON
State	:	GA
Zip	:	31808-6887
Country	:	US
Telephone Number	:	813-546-8186
Fax Number	:

Provider Business Practice Location Address
First Line	:	6361 TALOKAS LN STE C140-158
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31909-5642
Country	:	US
Telephone Number	:	855-832-6727
Fax Number	:	772-675-9100

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2019
Last Update Date	:	01/17/2023

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Directions to “ JENNIFER MCCARTY ” Practice Location

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