MEDICARE: MR. MICHAEL BRIAN MCCARTHY LCSW

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	1041C0700X	Clinical Social Worker	SW13703	FL
2	1041C0700X	Clinical Social Worker	R-069776	NY

General Provider Information

NPI Number	:	1790903417
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MICHAEL BRIAN MCCARTHY LCSW

Provider Business Mailing Address
First Line	:	12550 BISCAYNE BLVD STE 800
Second Line	:
City	:	NORTH MIAMI
State	:	FL
Zip	:	33181-2545
Country	:	US
Telephone Number	:	305-479-7068
Fax Number	:

Provider Business Practice Location Address
First Line	:	12550 BISCAYNE BLVD STE 800
Second Line	:
City	:	NORTH MIAMI
State	:	FL
Zip	:	33181-2545
Country	:	US
Telephone Number	:	305-479-7068
Fax Number	:

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

Provider Enumeration Date	:	04/20/2007
Last Update Date	:	07/21/2022

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