Healthcare Provider Details

I. General information

NPI: 1588910111
Provider Name (Legal Business Name): MICHELLE LYNNE MCCARTY MS, DD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHELLE SHELLY LYNNE MCCARTY MFT

II. Dates (important events)

Enumeration Date: 08/01/2012
Last Update Date: 11/13/2025
Certification Date: 11/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 BRIGITTE DR
TOLEDO OH
43614-2320
US

IV. Provider business mailing address

1221 BRIGITTE DR
TOLEDO OH
43614-2320
US

V. Phone/Fax

Practice location:
  • Phone: 702-358-6006
  • Fax:
Mailing address:
  • Phone: 702-358-6006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1003
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number1003
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: