Provider Demographics
NPI:1174265367
Name:MCCARTHY, MADISEN KAY (RBT)
Entity Type:Individual
Prefix:
First Name:MADISEN
Middle Name:KAY
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:MADISEN
Other - Middle Name:KAY
Other - Last Name:KUCERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NONE
Mailing Address - Street 1:11112 JOHN GALT BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68137-9838
Mailing Address - Country:US
Mailing Address - Phone:402-252-4438
Mailing Address - Fax:646-859-4440
Practice Address - Street 1:11112 JOHN GALT BLVD STE 100
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137-9838
Practice Address - Country:US
Practice Address - Phone:402-252-4438
Practice Address - Fax:646-859-4440
Is Sole Proprietor?:No
Enumeration Date:2022-04-08
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NERBT-24-325413106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician