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

Table of content: DR. PATRICK C MCCARTHY PHD, LICSW (NPI 1932199569)

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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