Provider Demographics
NPI:1770573909
Name:MCCARTHY, MARY KATHRYN (MD)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:KATHRYN
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1330 BEACON ST
Mailing Address - Street 2:SUITE 315
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-3282
Mailing Address - Country:US
Mailing Address - Phone:617-731-1800
Mailing Address - Fax:617-731-1801
Practice Address - Street 1:1330 BEACON ST.
Practice Address - Street 2:SUITE 315
Practice Address - City:ROSLINDALE
Practice Address - State:MA
Practice Address - Zip Code:02446-3202
Practice Address - Country:US
Practice Address - Phone:617-731-1800
Practice Address - Fax:617-731-1801
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-27
Last Update Date:2015-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA595292084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry