Provider Demographics
NPI:1508152869
Name:MCCARTHY, BEVERLY (LCSW)
Entity Type:Individual
Prefix:MS
First Name:BEVERLY
Middle Name:
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8088 PALM LN
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92410-4972
Mailing Address - Country:US
Mailing Address - Phone:909-821-9322
Mailing Address - Fax:
Practice Address - Street 1:8088 PALM LN
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92410-4972
Practice Address - Country:US
Practice Address - Phone:909-821-9322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-24
Last Update Date:2017-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical