Provider Demographics
NPI:1588953954
Name:MCCARTHY, PATRICIA ANN T (EDD, BCBA-D, LBA)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:ANN T
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:EDD, BCBA-D, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 MCELROY DR UNIT 1376
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-2377
Mailing Address - Country:US
Mailing Address - Phone:803-466-8260
Mailing Address - Fax:
Practice Address - Street 1:404 COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655
Practice Address - Country:US
Practice Address - Phone:803-466-8260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-06
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS200030103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1962701169OtherGROUP NPI FOR SINGLE OWNER LLC (AUTISM INSTITUTE OF SOUTH CAROLINA, LLC)
SC1962701169OtherGROUP NPI FOR SINGLE OWNER LLC (AUTISM INSTITUTE OF SOUTH CAROLINA, LLC)
SCEXG320Medicaid