1285648824 NPI number — SYLVIA LYNN MCCARTY LCSW

Table of content: SYLVIA LYNN MCCARTY LCSW (NPI 1285648824)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285648824 NPI number — SYLVIA LYNN MCCARTY LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCCARTY
Provider First Name:
SYLVIA
Provider Middle Name:
LYNN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

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:
1285648824
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/17/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 614
Provider Second Line Business Mailing Address:
607 HAMMOND PLAZA
Provider Business Mailing Address City Name:
HOPKINSVILLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
42241-0614
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
270-886-2205
Provider Business Mailing Address Fax Number:
270-886-0392

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1350 HWY 62 WEST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PRINCETON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42445
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-365-2008
Provider Business Practice Location Address Fax Number:
270-365-2009
Provider Enumeration Date:
07/28/2006

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: 104100000X , with the licence number:  1508 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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