Provider Demographics
NPI:1609942457
Name:MCCARTHY, JENNIFER P (LICSW)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:P
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:M
Other - Last Name:PARRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:12 SHADY LN
Mailing Address - Street 2:
Mailing Address - City:HOLDEN
Mailing Address - State:MA
Mailing Address - Zip Code:01520-2584
Mailing Address - Country:US
Mailing Address - Phone:508-446-3786
Mailing Address - Fax:508-835-4418
Practice Address - Street 1:47 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:WEST BOYLSTON
Practice Address - State:MA
Practice Address - Zip Code:01583-1301
Practice Address - Country:US
Practice Address - Phone:508-446-3786
Practice Address - Fax:508-835-4418
Is Sole Proprietor?:No
Enumeration Date:2006-11-24
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1031803104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA470034OtherTUSTS
MAPO7633OtherBCBS
MA598282000OtherMAGELLAN
MA2175484OtherCIGNA