Provider Demographics
NPI:1598034480
Name:MCCARTY, HUGH LYNN (LCSW)
Entity type:Individual
Prefix:MR
First Name:HUGH
Middle Name:LYNN
Last Name:MCCARTY
Suffix:
Gender:M
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:PO BOX 979
Mailing Address - Street 2:
Mailing Address - City:WISE
Mailing Address - State:VA
Mailing Address - Zip Code:24293-0979
Mailing Address - Country:US
Mailing Address - Phone:276-698-5473
Mailing Address - Fax:
Practice Address - Street 1:157 ROSS CARTER BLVD
Practice Address - Street 2:
Practice Address - City:DUFFIELD
Practice Address - State:VA
Practice Address - Zip Code:24244-5116
Practice Address - Country:US
Practice Address - Phone:276-698-5473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-21
Last Update Date:2012-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040056241041C0700X
TNLSW000000039211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAQ38308BMedicare PIN
VAQ38308AMedicare PIN