1932199569 NPI number — DR. PATRICK C MCCARTHY PHD, LICSW

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932199569 NPI number — DR. PATRICK C MCCARTHY PHD, LICSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCCARTHY
Provider First Name:
PATRICK
Provider Middle Name:
C
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHD, LICSW
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1932199569
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/24/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 71
Provider Second Line Business Mailing Address:
19 COUNTY ROAD
Provider Business Mailing Address City Name:
MATTAPOISETT
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02739-0071
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-758-3754
Provider Business Mailing Address Fax Number:
508-758-3755

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
19 COUNTY RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MATTAPOISETT
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02739-1584
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-758-3754
Provider Business Practice Location Address Fax Number:
508-758-3755
Provider Enumeration Date:
10/25/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  103259 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1851331 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 017882 . This is a "VALUEOPTIONS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 063493000 . This is a "MAGELLAN BEHAVIORAL HEALT" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1041394 . This is a "CIGNA BEHAVIORAL HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 126506 . This is a "COMPSYCH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 406307 . This is a "BLUE CHIP BCBS RI" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 757524 . This is a "TUFTS HEALTH CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 095058 . This is a "MANAGED HEALTH NETWORK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1P086418 . This is a "HUMAN AFFAIRS INT'L" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3851-7 . This is a "BCBS RI" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 5681738 . This is a "AETNA BEHAVIORAL HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 286320 . This is a "PRIVATE HEALTHCARE SYS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 6253793 . This is a "UNITED BEHAVIORAL HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: PM35876 , issued by the state of ( RI ) . This identifiers is of the category "MEDICAID".
  • Identifier: S017173 . This is a "CHAMPUS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1891898 . This is a "MASS BEHAVIORAL HEALTH PA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 25576 . This is a "MBC HEALTHNET" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: P01380 . This is a "BCBS MA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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