Provider Demographics
NPI:1871070383
Name:MCCARTHY, KADEEM OSHANE
Entity type:Individual
Prefix:
First Name:KADEEM
Middle Name:OSHANE
Last Name:MCCARTHY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2211
Mailing Address - Street 2:
Mailing Address - City:NANTUCKET
Mailing Address - State:MA
Mailing Address - Zip Code:02584-2211
Mailing Address - Country:US
Mailing Address - Phone:774-420-8884
Mailing Address - Fax:
Practice Address - Street 1:9B POINT JUDITH LN
Practice Address - Street 2:
Practice Address - City:NANTUCKET
Practice Address - State:MA
Practice Address - Zip Code:02554-5312
Practice Address - Country:US
Practice Address - Phone:774-420-8884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-26
Last Update Date:2018-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst