Provider Demographics
NPI:1588734016
Name:MCCARTHY, MICHELE A (AUD)
Entity type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:A
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:AUD
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 810
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03755-0810
Mailing Address - Country:US
Mailing Address - Phone:603-308-1472
Mailing Address - Fax:
Practice Address - Street 1:2300 SOUTHWOOD DR
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03063-1818
Practice Address - Country:US
Practice Address - Phone:603-308-1472
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHA504231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30434317Medicaid
033964Medicare ID - Type Unspecified