Provider Demographics
NPI:1235698275
Name:MCCARTHY, MELISSA MARIA (CRC, CPRP)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:MARIA
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:CRC, CPRP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4483 US NORTH 42
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-1934
Mailing Address - Country:US
Mailing Address - Phone:513-536-0050
Mailing Address - Fax:513-204-3476
Practice Address - Street 1:4483 US NORTH 42
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-1934
Practice Address - Country:US
Practice Address - Phone:513-536-0050
Practice Address - Fax:513-204-3476
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-19
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH00047853225C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor