1750321451 NPI number — MRS. CATHERINE H. MCCOOL MSW LICSW

Table of content: MRS. CATHERINE H. MCCOOL MSW LICSW (NPI 1750321451)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750321451 NPI number — MRS. CATHERINE H. MCCOOL MSW LICSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCCOOL
Provider First Name:
CATHERINE
Provider Middle Name:
H.
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MSW LICSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HORAN
Provider Other First Name:
CATHEIRNE
Provider Other Middle Name:
A
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LICSW
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1750321451
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/08/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
115 MILL ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BELMONT
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02478-1041
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
617-855-2874
Provider Business Mailing Address Fax Number:
617-855-3470

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
115 MILL ST MCLEAN HOSPITAL
Provider Second Line Business Practice Location Address:
WYMAN BUILDING
Provider Business Practice Location Address City Name:
BELMONT
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02478-1064
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-855-2874
Provider Business Practice Location Address Fax Number:
617-855-3569
Provider Enumeration Date:
06/08/2006

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: 1041C0700X , with the licence number:  1023534 , 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)





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