Provider Demographics
NPI:1417545948
Name:MCCARTHY, KATIE E
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:E
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1036 ROLLING PASS
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-2753
Mailing Address - Country:US
Mailing Address - Phone:224-545-0175
Mailing Address - Fax:
Practice Address - Street 1:1036 ROLLING PASS
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60025-2753
Practice Address - Country:US
Practice Address - Phone:224-545-0175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-10
Last Update Date:2021-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health