Provider Demographics
NPI:1548385396
Name:MCCARTHY, AUDRA E (LMHC)
Entity Type:Individual
Prefix:
First Name:AUDRA
Middle Name:E
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5800 OSUNA RD NE APT 215
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-6255
Mailing Address - Country:US
Mailing Address - Phone:505-350-1706
Mailing Address - Fax:
Practice Address - Street 1:2403 SAN MATEO BLVD NE STE S14
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-4081
Practice Address - Country:US
Practice Address - Phone:505-830-1871
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMT-0101641101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health