Provider Demographics
NPI:1477130458
Name:MCCARTNEY, MAUREEN ERIN (LMFT)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:ERIN
Last Name:MCCARTNEY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 12249
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92112-3249
Mailing Address - Country:US
Mailing Address - Phone:619-693-8130
Mailing Address - Fax:
Practice Address - Street 1:600 W BROADWAY
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101-3311
Practice Address - Country:US
Practice Address - Phone:619-693-8130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-25
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT50144106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist