Provider Demographics
NPI:1518400753
Name:MCCARTHY, PHYLLIS (CIHC)
Entity Type:Individual
Prefix:
First Name:PHYLLIS
Middle Name:
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:CIHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 BASSWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:FT WRIGHT
Mailing Address - State:KY
Mailing Address - Zip Code:41011-3772
Mailing Address - Country:US
Mailing Address - Phone:859-250-8367
Mailing Address - Fax:
Practice Address - Street 1:129 BASSWOOD CIR
Practice Address - Street 2:
Practice Address - City:FT WRIGHT
Practice Address - State:KY
Practice Address - Zip Code:41011-3772
Practice Address - Country:US
Practice Address - Phone:859-250-8367
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-21
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator