Provider Demographics
NPI:1295080943
Name:MCCARTHY, KEVIN THOMAS JOHN (MA)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:THOMAS JOHN
Last Name:MCCARTHY
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1465 CLAYTON ST
Mailing Address - Street 2:APT 4
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-2474
Mailing Address - Country:US
Mailing Address - Phone:720-257-1950
Mailing Address - Fax:
Practice Address - Street 1:901 ENGLEWOOD PKWY
Practice Address - Street 2:#118
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80110-2305
Practice Address - Country:US
Practice Address - Phone:303-935-5200
Practice Address - Fax:303-648-5002
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-18
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst