Provider Demographics
NPI:1770355406
Name:MCCARTY, JESSIE LEE (LCSW)
Entity type:Individual
Prefix:
First Name:JESSIE
Middle Name:LEE
Last Name:MCCARTY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JESSIE
Other - Middle Name:LEE
Other - Last Name:HALTERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4311 STONEHILL CT
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76502-3133
Mailing Address - Country:US
Mailing Address - Phone:254-462-7141
Mailing Address - Fax:
Practice Address - Street 1:4311 STONEHILL CT
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76502-3133
Practice Address - Country:US
Practice Address - Phone:254-462-7141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-25
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX669431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical