Active NPI
Sean Robert McCarthy, MA, LPC INTERN
- Mental Health Counselor
- Salem, OR
National Provider Identifier
1174113328
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- R4766
- Practice address
- 2478 13TH St SE
Salem, OR 97302-2522 - Phone
- (503) 485-3615
- NPI assigned
- Jan 21, 2021
- Sex
- Male
- Sole proprietor
- No
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 | R4766 | OR | Primary |
Addresses
Primary practice location
2478 13TH St SE
Salem, OR 97302-2522
Mailing address
842 Moneda Ave N
Keizer, OR 97303-6391
Phone (503) 791-9353
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R4766 | OR | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611187200000",
"number": "1174113328",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "842 MONEDA AVE N",
"city": "KEIZER",
"state": "OR",
"postal_code": "973036391",
"telephone_number": "503-791-9353"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2478 13TH ST SE",
"city": "SALEM",
"state": "OR",
"postal_code": "973022522",
"telephone_number": "503-485-3615"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCARTHY",
"first_name": "SEAN",
"middle_name": "ROBERT",
"credential": "MA, LPC INTERN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-01-21",
"last_updated": "2021-01-21",
"certification_date": "2021-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OR",
"license": "R4766",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salem, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.