Healthcare Provider Details

I. General information

NPI: 1629602438
Provider Name (Legal Business Name): CATHERINE ELEANOR MCCARTHY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/02/2020
Last Update Date: 07/11/2023
Certification Date: 07/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 W 31ST ST FL 3
NEW YORK NY
10001-3407
US

IV. Provider business mailing address

330 W 58TH ST STE 401
NEW YORK NY
10019-1821
US

V. Phone/Fax

Practice location:
  • Phone: 917-991-8417
  • Fax:
Mailing address:
  • Phone: 212-575-4769
  • Fax: 212-877-5504

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number095404
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: