Provider Demographics
NPI:1275685307
Name:CAM MCCARTHY MPH PHD PA
Entity Type:Organization
Organization Name:CAM MCCARTHY MPH PHD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCARTHY
Authorized Official - Suffix:
Authorized Official - Credentials:MPH PHD
Authorized Official - Phone:407-895-9700
Mailing Address - Street 1:1033 MONTANA STREET
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-1652
Mailing Address - Country:US
Mailing Address - Phone:407-895-9700
Mailing Address - Fax:407-228-7455
Practice Address - Street 1:1033 MONTANA STREET
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-1652
Practice Address - Country:US
Practice Address - Phone:407-895-9700
Practice Address - Fax:407-228-7455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL002425101YM0800X
CA12792106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty