Provider Demographics
NPI:1336838671
Name:MCCARTHY, CALLIE MARIE (RBT)
Entity Type:Individual
Prefix:
First Name:CALLIE
Middle Name:MARIE
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 E NASSAU AVE
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-4731
Mailing Address - Country:US
Mailing Address - Phone:314-606-3812
Mailing Address - Fax:
Practice Address - Street 1:3131 S VAUGHN WAY
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-3511
Practice Address - Country:US
Practice Address - Phone:303-755-5534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-03
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician