Provider Demographics
NPI:1740585322
Name:MCCARTHY, AMANDA C (PD, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:C
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:PD, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 LINDEN ST
Mailing Address - Street 2:
Mailing Address - City:BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-3459
Mailing Address - Country:US
Mailing Address - Phone:516-967-0167
Mailing Address - Fax:
Practice Address - Street 1:411 LINDEN ST
Practice Address - Street 2:
Practice Address - City:BELLMORE
Practice Address - State:NY
Practice Address - Zip Code:11710-3459
Practice Address - Country:US
Practice Address - Phone:616-967-0167
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-13
Last Update Date:2011-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1-09-5857103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst