Provider Demographics
NPI:1831666734
Name:MCCARTHY, MARILYN LORENE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MARILYN
Middle Name:LORENE
Last Name:MCCARTHY
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 1:153 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06470-2791
Mailing Address - Country:US
Mailing Address - Phone:203-350-0866
Mailing Address - Fax:
Practice Address - Street 1:153 S MAIN ST
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:CT
Practice Address - Zip Code:06470-2791
Practice Address - Country:US
Practice Address - Phone:203-350-0866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-29
Last Update Date:2018-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0048911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical