Provider Demographics
NPI:1164837498
Name:MCCARTHY, CLARE (MS)
Entity Type:Individual
Prefix:MRS
First Name:CLARE
Middle Name:
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 WASHINGTON BLVD
Mailing Address - Street 2:APT 3F
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-4166
Mailing Address - Country:US
Mailing Address - Phone:859-619-0232
Mailing Address - Fax:
Practice Address - Street 1:1448 N MILWAUKEE AVE
Practice Address - Street 2:SUITE # 201
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-9225
Practice Address - Country:US
Practice Address - Phone:859-619-0232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-25
Last Update Date:2014-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180009111101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional