Provider Demographics
NPI:1699927012
Name:MC CARTHY, LAURA (LCSW)
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:
Last Name:MC CARTHY
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 1:621 BARD AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10310-3017
Mailing Address - Country:US
Mailing Address - Phone:917-929-2819
Mailing Address - Fax:718-983-0348
Practice Address - Street 1:115 LATHROP AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-2277
Practice Address - Country:US
Practice Address - Phone:917-929-2819
Practice Address - Fax:718-983-0348
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-16
Last Update Date:2009-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY070343104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker