Provider Demographics
NPI:1194182923
Name:MCCARTHY, KRISTIN (LCSW)
Entity type:Individual
Prefix:MISS
First Name:KRISTIN
Middle Name:
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:
Other - Last Name:BONIFACE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2312 WHITEHORSE MERCERVILLE ROAD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619
Mailing Address - Country:US
Mailing Address - Phone:609-219-1600
Mailing Address - Fax:609-394-0023
Practice Address - Street 1:2312 WHITEHORSE MERCERVILLE ROAD
Practice Address - Street 2:SUITE 207
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619
Practice Address - Country:US
Practice Address - Phone:609-219-1600
Practice Address - Fax:609-394-0023
Is Sole Proprietor?:No
Enumeration Date:2016-01-25
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
NJ44SC063365001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker