Provider Demographics
NPI:1215157250
Name:MCCARTHY, KATHLEEN MAURA (MSW, LICSW)
Entity type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:MAURA
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:MISS
Other - First Name:KATHLEEN
Other - Middle Name:MAURA
Other - Last Name:ROWE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LICSW
Mailing Address - Street 1:103 JOHNSON ST
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01902-4001
Mailing Address - Country:US
Mailing Address - Phone:781-593-2727
Mailing Address - Fax:781-593-2542
Practice Address - Street 1:103 JOHNSON ST
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01902-4001
Practice Address - Country:US
Practice Address - Phone:781-593-2727
Practice Address - Fax:781-593-2542
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10274441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical