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NPI Code Detail

MEDICARE: MS. CAROLYN MINTON MCCARTHY LCSW, CASAC

MEDICARE: MS. CAROLYN MINTON MCCARTHY LCSW, CASAC
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
11041C0700XClinical Social WorkerRO52394NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1187588POTHERNYHIP 56432908
20007856264OTHERNYAETNA PIN
32700983OTHERMHN PROVIDER ID

General Provider Information

NPI Number : 1174628671
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CAROLYN MINTON MCCARTHY LCSW, CASAC
Provider Business Mailing Address
First Line : 337 MILTON AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10306-5615
Country : US
Telephone Number : 718-351-8544
Fax Number : 718-370-2150
Provider Business Practice Location Address
First Line : 201 BRYSON AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10314-1922
Country : US
Telephone Number : 917-270-1917
Fax Number : 718-370-2150
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2006
Last Update Date : 07/08/2007

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