Provider Demographics
NPI:1780038703
Name:MCCARTHY, ALLIE JANE
Entity Type:Individual
Prefix:
First Name:ALLIE
Middle Name:JANE
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:GLOUCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01930-2633
Mailing Address - Country:US
Mailing Address - Phone:978-290-8042
Mailing Address - Fax:
Practice Address - Street 1:7 MADISON AVE
Practice Address - Street 2:
Practice Address - City:GLOUCESTER
Practice Address - State:MA
Practice Address - Zip Code:01930-2633
Practice Address - Country:US
Practice Address - Phone:978-290-8042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-15
Last Update Date:2016-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAHP526009702OtherHARVARD PILGRIM HEALTH CARE