Provider Demographics
NPI:1629552534
Name:MCCARY, MARTIN A (BSW)
Entity Type:Individual
Prefix:
First Name:MARTIN
Middle Name:A
Last Name:MCCARY
Suffix:
Gender:M
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 E 84TH DR
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-6394
Mailing Address - Country:US
Mailing Address - Phone:219-474-2062
Mailing Address - Fax:
Practice Address - Street 1:233 E 84TH DR
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-6394
Practice Address - Country:US
Practice Address - Phone:219-474-2062
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-18
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator