Provider Demographics
NPI:1164524831
Name:MCCARTHY, ABBY JANE (LCSW)
Entity Type:Individual
Prefix:
First Name:ABBY
Middle Name:JANE
Last Name:MCCARTHY
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 1:2401 COUNTY ROAD 1200 N
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:IL
Mailing Address - Zip Code:61738-9277
Mailing Address - Country:US
Mailing Address - Phone:309-212-3342
Mailing Address - Fax:
Practice Address - Street 1:600 S FAYETTE ST STE 4
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:IL
Practice Address - Zip Code:61738-1478
Practice Address - Country:US
Practice Address - Phone:309-212-3342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2017-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490136021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical