MEDICARE: KATHERINE MCCUSKER MHC-LP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor		NY

General Provider Information

NPI Number	:	1164270112
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE MCCUSKER MHC-LP

Provider Business Mailing Address
First Line	:	2701 MAGAZINE ST UPPR
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70130-5628
Country	:	US
Telephone Number	:	504-756-4764
Fax Number	:

Provider Business Practice Location Address
First Line	:	1582 E 22ND ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-5154
Country	:	US
Telephone Number	:	646-762-0707
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/07/2024
Last Update Date	:	05/07/2024

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