Provider Demographics
NPI:1306133970
Name:MCCARTHY, CORINNE ELLEN (LMHC)
Entity type:Individual
Prefix:MRS
First Name:CORINNE
Middle Name:ELLEN
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 AVIATION RD
Mailing Address - Street 2:
Mailing Address - City:COLONIE
Mailing Address - State:NY
Mailing Address - Zip Code:12205-1141
Mailing Address - Country:US
Mailing Address - Phone:518-438-9596
Mailing Address - Fax:518-438-9598
Practice Address - Street 1:21 AVIATION RD
Practice Address - Street 2:
Practice Address - City:COLONIE
Practice Address - State:NY
Practice Address - Zip Code:12205-1141
Practice Address - Country:US
Practice Address - Phone:518-438-9596
Practice Address - Fax:518-438-9598
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-05
Last Update Date:2011-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY100550360101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health