Provider Demographics
NPI:1811363831
Name:MCCARTY, STEPHANIE (LCSW)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:MCCARTY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 MORELLO AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:CA
Mailing Address - Zip Code:94553-4707
Mailing Address - Country:US
Mailing Address - Phone:925-788-0350
Mailing Address - Fax:925-335-3318
Practice Address - Street 1:1220 MORELLO AVE STE 100
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553-4707
Practice Address - Country:US
Practice Address - Phone:925-788-0350
Practice Address - Fax:925-335-3318
Is Sole Proprietor?:No
Enumeration Date:2015-08-13
Last Update Date:2018-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA295721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical