Provider Demographics
NPI:1437713310
Name:MCCARTHY, KATHERINE MARY (MS CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:MARY
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3707 HUDSON ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-5232
Mailing Address - Country:US
Mailing Address - Phone:845-598-4789
Mailing Address - Fax:
Practice Address - Street 1:3707 HUDSON ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-5232
Practice Address - Country:US
Practice Address - Phone:845-598-4789
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-26
Last Update Date:2019-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05726235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist