Provider Demographics
NPI:1851420848
Name:MCCARTHY, JOSEPH (LPC)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:MCCARTHY
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7012 CAMELBACK DR NE
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:MI
Mailing Address - Zip Code:49341-9684
Mailing Address - Country:US
Mailing Address - Phone:616-874-0219
Mailing Address - Fax:
Practice Address - Street 1:516 CHERRY ST SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-4702
Practice Address - Country:US
Practice Address - Phone:616-456-6135
Practice Address - Fax:616-771-9761
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI60925101Y00000X
MI6401007633101YP2500X
MI101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)