Provider Demographics
NPI:1770724197
Name:MCDONOUGH, MARYCATE (BCBA)
Entity type:Individual
Prefix:MRS
First Name:MARYCATE
Middle Name:
Last Name:MCDONOUGH
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:489 GREGORY LN
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-1919
Mailing Address - Country:US
Mailing Address - Phone:610-696-1565
Mailing Address - Fax:267-200-0060
Practice Address - Street 1:489 GREGORY LN
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-1919
Practice Address - Country:US
Practice Address - Phone:610-696-1565
Practice Address - Fax:267-200-0060
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-14
Last Update Date:2009-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA1-03-1364103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst