Provider Demographics
NPI:1316568678
Name:MCCARTY, CHRISTY M (BSW,LSW)
Entity type:Individual
Prefix:
First Name:CHRISTY
Middle Name:M
Last Name:MCCARTY
Suffix:
Gender:F
Credentials:BSW,LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 188
Mailing Address - Street 2:
Mailing Address - City:WEST LIBERTY
Mailing Address - State:OH
Mailing Address - Zip Code:43357-0188
Mailing Address - Country:US
Mailing Address - Phone:937-465-0010
Mailing Address - Fax:888-925-1725
Practice Address - Street 1:550 N DETROIT ST
Practice Address - Street 2:
Practice Address - City:WEST LIBERTY
Practice Address - State:OH
Practice Address - Zip Code:43357-9540
Practice Address - Country:US
Practice Address - Phone:937-465-0010
Practice Address - Fax:888-925-1725
Is Sole Proprietor?:No
Enumeration Date:2020-04-28
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.1502437104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker