Provider Demographics
NPI:1083328926
Name:MCCARTHY, TRAVIS (MA)
Entity Type:Individual
Prefix:MR
First Name:TRAVIS
Middle Name:
Last Name:MCCARTHY
Suffix:
Gender:M
Credentials:MA
Other - Prefix:MR
Other - First Name:TRAVIS
Other - Middle Name:
Other - Last Name:CIEMPA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:124 AMERICAN LEGION DR
Mailing Address - Street 2:
Mailing Address - City:NORTH ADAMS
Mailing Address - State:MA
Mailing Address - Zip Code:01247-3942
Mailing Address - Country:US
Mailing Address - Phone:413-664-4541
Mailing Address - Fax:413-662-3311
Practice Address - Street 1:124 AMERICAN LEGION DR
Practice Address - Street 2:
Practice Address - City:NORTH ADAMS
Practice Address - State:MA
Practice Address - Zip Code:01247-3942
Practice Address - Country:US
Practice Address - Phone:413-664-4541
Practice Address - Fax:413-662-3311
Is Sole Proprietor?:No
Enumeration Date:2023-01-05
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor