Provider Demographics
NPI:1760675292
Name:MCCARTY, SONI
Entity Type:Individual
Prefix:
First Name:SONI
Middle Name:
Last Name:MCCARTY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SONI
Other - Middle Name:
Other - Last Name:MCCARTY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHC
Mailing Address - Street 1:1385 W STATE ROAD 434 STE 207
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32750-6214
Mailing Address - Country:US
Mailing Address - Phone:407-461-1978
Mailing Address - Fax:407-960-3686
Practice Address - Street 1:1385 W STATE ROAD 434 STE 207
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-6214
Practice Address - Country:US
Practice Address - Phone:407-461-1978
Practice Address - Fax:407-960-3686
Is Sole Proprietor?:No
Enumeration Date:2007-08-17
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH7007101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health