Provider Demographics
NPI:1699286948
Name:MCCARTHY, MELISSSA M (BCBA)
Entity type:Individual
Prefix:
First Name:MELISSSA
Middle Name:M
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 MAIN DUNSTABLE RD STE 150
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-3640
Mailing Address - Country:US
Mailing Address - Phone:844-962-4222
Mailing Address - Fax:
Practice Address - Street 1:361 HANOVER ST
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-3959
Practice Address - Country:US
Practice Address - Phone:844-962-4222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-13
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110026526EMedicaid