Healthcare Provider Details

I. General information

NPI: 1689769150
Provider Name (Legal Business Name): MARK REDMOND MCCARTHY LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3101 BROADWAY SUITE 220
KANSAS CITY MO
64111
US

IV. Provider business mailing address

3101 BROADWAY SUITE 220
KANSAS CITY MO
64111
US

V. Phone/Fax

Practice location:
  • Phone: 816-931-0011
  • Fax: 816-531-7740
Mailing address:
  • Phone: 816-931-0011
  • Fax: 816-531-7740

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCS001386
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCS001386
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: