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General NPI Number Information
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NPI Number | 1073601662
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Entity Type | Individual
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Provider Name | MARY A MCCARTHY LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 06/05/2025
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Provider Practice Location Address
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Address Line | 1011 WASHINGTON ST
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City | MONTPELIER
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State | ID
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Zip | 83254-5091
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Country | US
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Telephone | 307-413-5803
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Fax |
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Provider Business Mailing Address
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Address Line | 1011 WASHINGTON ST
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City | MONTPELIER
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State | ID
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Zip | 83254-5091
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Country | US
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Telephone | 307-413-5803
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 489
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License Number State | AK
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CSWS1104
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License Number State | AK
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 10144643-3501
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License Number State | UT
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 1104
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License Number State | AK
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Taxonomy #5
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW-1101
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License Number State | WY
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Taxonomy #6
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 125
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License Number State | GU
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Taxonomy #7
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW-36300
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License Number State | ID
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