Provider Demographics
NPI:1114581915
Name:MCCARTY, CARL LOYD III (LMFT)
Entity type:Individual
Prefix:
First Name:CARL
Middle Name:LOYD
Last Name:MCCARTY
Suffix:III
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47804-2771
Mailing Address - Country:US
Mailing Address - Phone:812-231-8438
Mailing Address - Fax:812-231-8191
Practice Address - Street 1:431 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:IN
Practice Address - Zip Code:47424-1460
Practice Address - Country:US
Practice Address - Phone:812-384-9452
Practice Address - Fax:812-384-9445
Is Sole Proprietor?:No
Enumeration Date:2019-04-26
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN85000344A106H00000X
IN35002135A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist