Healthcare Provider Details

I. General information

NPI: 1861551285
Provider Name (Legal Business Name): LEAH MARIE MCCARTT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 09/01/2023
Certification Date: 09/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 PATEWOOD DR STE A100
GREENVILLE SC
29615-6302
US

IV. Provider business mailing address

300 E MCBEE AVE FL 4
GREENVILLE SC
29601-2842
US

V. Phone/Fax

Practice location:
  • Phone: 644-545-6128
  • Fax: 864-454-5121
Mailing address:
  • Phone: 864-695-6065
  • Fax: 843-667-1362

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number19469
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: