Healthcare Provider Details

I. General information

NPI: 1104507797
Provider Name (Legal Business Name): CASZ MCCARTHY LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2023
Last Update Date: 07/27/2023
Certification Date: 07/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1023 W IRVING PARK RD
CHICAGO IL
60613-2913
US

IV. Provider business mailing address

1023 W IRVING PARK RD
CHICAGO IL
60613-2913
US

V. Phone/Fax

Practice location:
  • Phone: 773-388-1600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number105974
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: