Provider Demographics
NPI:1043788649
Name:MCCARRICK, ANGEL RILEY (LMSW)
Entity Type:Individual
Prefix:MR
First Name:ANGEL
Middle Name:RILEY
Last Name:MCCARRICK
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:353 COLLINGTON DR
Mailing Address - Street 2:
Mailing Address - City:RONKONKOMA
Mailing Address - State:NY
Mailing Address - Zip Code:11779-4914
Mailing Address - Country:US
Mailing Address - Phone:631-827-5946
Mailing Address - Fax:
Practice Address - Street 1:7555 MAIN RD
Practice Address - Street 2:
Practice Address - City:MATTITUCK
Practice Address - State:NY
Practice Address - Zip Code:11952-1516
Practice Address - Country:US
Practice Address - Phone:631-298-8642
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-13
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker