Provider Demographics
NPI:1639541527
Name:MACCARTHY, JACQUELINE BRICE (LMHC)
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:BRICE
Last Name:MACCARTHY
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 1:421 COMMERCIAL CT STE B
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34292-1656
Mailing Address - Country:US
Mailing Address - Phone:941-244-4377
Mailing Address - Fax:
Practice Address - Street 1:421 COMMERCIAL CT STE B
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34292-1656
Practice Address - Country:US
Practice Address - Phone:941-422-4377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-30
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health