Provider Demographics
NPI:1851061634
Name:MCCARTHY, LAURA E (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:E
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2021 GLORIA CIR NE
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32905-5151
Mailing Address - Country:US
Mailing Address - Phone:321-961-8487
Mailing Address - Fax:
Practice Address - Street 1:2021 GLORIA CIR NE
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32905-5151
Practice Address - Country:US
Practice Address - Phone:321-961-8487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-14
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMCAP100159101YA0400X
FLMH12702101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)