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Individual

SUZANNE ROSE MCCARTHY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCPC

Contact information

Practice address
165 LANCASTER ST, PORTLAND, ME 04101-2406
(207) 874-1030
(207) 874-1044
Mailing address
78 ATLANTIC PLACE, SOUTH PORTLAND, ME 04106-2316
(207) 842-7701
(207) 842-7773

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CC2552
ME
101YP2500X
Professional Counselor
CC2552
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
290030099
ME
Enumeration date
05/28/2006
Last updated
09/11/2012
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