Provider Demographics
NPI:1083328926
Name:MCCARTHY, TRAVIS (MA)
Entity type:Individual
Prefix:MR
First Name:TRAVIS
Middle Name:
Last Name:MCCARTHY
Suffix:
Gender:M
Credentials:MA
Other - Prefix:MR
Other - First Name:TRAVIS
Other - Middle Name:
Other - Last Name:CIEMPA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LMHC, RDT
Mailing Address - Street 1:6 BURNS LN
Mailing Address - Street 2:
Mailing Address - City:ADAMS
Mailing Address - State:MA
Mailing Address - Zip Code:01220-1728
Mailing Address - Country:US
Mailing Address - Phone:413-662-9860
Mailing Address - Fax:
Practice Address - Street 1:6 BURNS LN
Practice Address - Street 2:
Practice Address - City:ADAMS
Practice Address - State:MA
Practice Address - Zip Code:01220-1728
Practice Address - Country:US
Practice Address - Phone:413-662-9860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-05
Last Update Date:2025-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA897101200000X
MALMHC10002897101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101200000XBehavioral Health & Social Service ProvidersDrama Therapist