Provider Demographics
NPI:1649327891
Name:MCCARTHY COUNSELING ASSOCIATES, PA
Entity type:Organization
Organization Name:MCCARTHY COUNSELING ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:MCCARTHY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LPC, CCMHC
Authorized Official - Phone:843-497-5240
Mailing Address - Street 1:4603 OLEANDER DR
Mailing Address - Street 2:SUITE # 1
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29577-5738
Mailing Address - Country:US
Mailing Address - Phone:843-497-5240
Mailing Address - Fax:843-497-1129
Practice Address - Street 1:4603 OLEANDER DR
Practice Address - Street 2:SUITE # 1
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29577-5738
Practice Address - Country:US
Practice Address - Phone:843-497-5240
Practice Address - Fax:843-497-1129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2009-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLPC#1719101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty