Provider Demographics
NPI:1093427304
Name:ALLIE MCCARTHY PSYCHOLOGY LLC
Entity Type:Organization
Organization Name:ALLIE MCCARTHY PSYCHOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDRA
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:LOESCH
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:516-967-6602
Mailing Address - Street 1:7 CONANT RD APT 23
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01890-1162
Mailing Address - Country:US
Mailing Address - Phone:516-967-6602
Mailing Address - Fax:
Practice Address - Street 1:7 CONANT RD APT 23
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:MA
Practice Address - Zip Code:01890-1162
Practice Address - Country:US
Practice Address - Phone:516-967-6602
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-19
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1548778129Medicaid