Active NPI
Ken E McCarty, LMFT
- Mental Health Counselor
- Kodiak, AK
National Provider Identifier
1083765317
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MFC37996
- Practice address
- 1423 Simeonof St
Kodiak, AK 99615-6452 - Phone
- (530) 515-1089
- Fax
- (530) 241-9221
- NPI assigned
- Jan 15, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MFC37996 | CA | Primary |
Addresses
Primary practice location
1423 Simeonof St
Kodiak, AK 99615-6452
Mailing address
1423 Simeonof St.
Kodiak, AK 99615
Phone (530) 515-1089
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MFC37996 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1257465600000",
"number": "1083765317",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1423 SIMEONOF ST.",
"city": "KODIAK",
"state": "AK",
"postal_code": "99615",
"telephone_number": "530-515-1089",
"fax_number": "530-241-9221"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1423 SIMEONOF ST",
"city": "KODIAK",
"state": "AK",
"postal_code": "996156452",
"telephone_number": "530-515-1089",
"fax_number": "530-241-9221"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCARTY",
"first_name": "KEN",
"middle_name": "E",
"name_prefix": "Mr.",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-15",
"last_updated": "2009-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "MFC37996",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kodiak, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.