Provider Demographics
NPI:1952346488
Name:MCCARTY, INGRID (MSW,LCSW)
Entity Type:Individual
Prefix:
First Name:INGRID
Middle Name:
Last Name:MCCARTY
Suffix:
Gender:F
Credentials:MSW,LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2646 HIGHWAY 109
Mailing Address - Street 2:#212
Mailing Address - City:WILDWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63040-1162
Mailing Address - Country:US
Mailing Address - Phone:636-458-7595
Mailing Address - Fax:636-458-7544
Practice Address - Street 1:2646 HIGHWAY 109
Practice Address - Street 2:#212
Practice Address - City:WILDWOOD
Practice Address - State:MO
Practice Address - Zip Code:63040-1162
Practice Address - Country:US
Practice Address - Phone:636-458-7595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-18
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO005594101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor