Provider Demographics
NPI:1376668590
Name:MCCARTNEY, JOHN R (PHD,)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:R
Last Name:MCCARTNEY
Suffix:
Gender:M
Credentials:PHD,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 26TH AVE
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:AL
Mailing Address - Zip Code:35476-5235
Mailing Address - Country:US
Mailing Address - Phone:205-339-6669
Mailing Address - Fax:
Practice Address - Street 1:3100 26TH AVE
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:AL
Practice Address - Zip Code:35476-5235
Practice Address - Country:US
Practice Address - Phone:205-339-6669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL526103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist