Provider Demographics
NPI:1750321451
Name:MCCOOL, CATHERINE H (MSW LICSW)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:H
Last Name:MCCOOL
Suffix:
Gender:F
Credentials:MSW LICSW
Other - Prefix:MS
Other - First Name:CATHEIRNE
Other - Middle Name:A
Other - Last Name:HORAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:115 MILL ST
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:MA
Mailing Address - Zip Code:02478-1041
Mailing Address - Country:US
Mailing Address - Phone:617-855-2874
Mailing Address - Fax:617-855-3470
Practice Address - Street 1:115 MILL ST MCLEAN HOSPITAL
Practice Address - Street 2:WYMAN BUILDING
Practice Address - City:BELMONT
Practice Address - State:MA
Practice Address - Zip Code:02478-1064
Practice Address - Country:US
Practice Address - Phone:617-855-2874
Practice Address - Fax:617-855-3569
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-08
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10235341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP06876Medicare ID - Type Unspecified