Provider Demographics
NPI:1427031327
Name:MCCARTHY, MAUREEN THERESE (LCSW)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:THERESE
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 HEMLOCK RD
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06515-2616
Mailing Address - Country:US
Mailing Address - Phone:475-244-2575
Mailing Address - Fax:
Practice Address - Street 1:79 TRUMBULL ST STE 2
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-3782
Practice Address - Country:US
Practice Address - Phone:475-244-2575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-23
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT005505104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004167715Medicaid
CT004167715Medicaid
Q01651Medicare UPIN