Provider Demographics
NPI:1346764875
Name:MCDADE, CARLY MICHEL (MS, LMFT)
Entity Type:Individual
Prefix:
First Name:CARLY
Middle Name:MICHEL
Last Name:MCDADE
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8200 FLOURTOWN AVE REAR 1C
Mailing Address - Street 2:
Mailing Address - City:WYNDMOOR
Mailing Address - State:PA
Mailing Address - Zip Code:19038-7969
Mailing Address - Country:US
Mailing Address - Phone:267-723-7169
Mailing Address - Fax:
Practice Address - Street 1:8200 FLOURTOWN AVE REAR 1C
Practice Address - Street 2:
Practice Address - City:WYNDMOOR
Practice Address - State:PA
Practice Address - Zip Code:19038-7969
Practice Address - Country:US
Practice Address - Phone:267-723-7169
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-26
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist