Provider Demographics
NPI:1144689803
Name:MCCARTHY, LAURA (OTR/L, CLT)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:OTR/L, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10010 FALLS OF NEUSE RD
Mailing Address - Street 2:SUITE 09
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27614-8494
Mailing Address - Country:US
Mailing Address - Phone:919-350-1508
Mailing Address - Fax:919-350-1475
Practice Address - Street 1:10010 FALLS OF NEUSE RD
Practice Address - Street 2:SUITE 09
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27614-8494
Practice Address - Country:US
Practice Address - Phone:919-350-1508
Practice Address - Fax:919-350-1475
Is Sole Proprietor?:No
Enumeration Date:2016-02-23
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5661225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1007144OtherNBCOT
NC5661OtherNCBOT LICENSE