Provider Demographics
NPI:1982853834
Name:DR MCCARTY CLINICAL PSYCHOLOGIST LLC
Entity Type:Organization
Organization Name:DR MCCARTY CLINICAL PSYCHOLOGIST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:RHETT
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCARTY
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:573-635-7166
Mailing Address - Street 1:312 E CAPITOL AVE
Mailing Address - Street 2:DR MCCARTY CLINICAL PSYCHOLOGIST LLC
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65101-3055
Mailing Address - Country:US
Mailing Address - Phone:573-635-7166
Mailing Address - Fax:573-634-7431
Practice Address - Street 1:312 E CAPITOL AVE
Practice Address - Street 2:DR MCCARTY CLINICAL PSYCHOLOGIST LLC
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65101-3055
Practice Address - Country:US
Practice Address - Phone:573-635-7166
Practice Address - Fax:573-634-7431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-16
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty