Provider Demographics
NPI:1174213003
Name:MCCARTHY, MEGAN LYNAE (CADC II CRM II QMHA)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:LYNAE
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:CADC II CRM II QMHA
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:LYNAE
Other - Last Name:MURPHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CADC II CRM II QMHA
Mailing Address - Street 1:2004 COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:PHILOMATH
Mailing Address - State:OR
Mailing Address - Zip Code:97370-9534
Mailing Address - Country:US
Mailing Address - Phone:541-740-1650
Mailing Address - Fax:
Practice Address - Street 1:2004 COLLEGE ST
Practice Address - Street 2:
Practice Address - City:PHILOMATH
Practice Address - State:OR
Practice Address - Zip Code:97370-9534
Practice Address - Country:US
Practice Address - Phone:541-740-1650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-12
Last Update Date:2024-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR15-12-15101YA0400X
OR24-CRM-II-0291175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)