| Doctor Name: | MR. KEN E MCCARTY |
| NPI Number: | 1083765317 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LMFT |
| License Number: | MFC37996 |
| Business Practice Address: | 1423 Simeonof St Kodiak, AK - 996156452 |
| Business Phone Number: | 5305151089 |
| Business Fax Number: | 5302419221 |
| Mailing Address: | 1423 Simeonof St., KODIAK |
| State: | AK |
| Postal Code: | 99615 |
| Phone Number: | 5305151089 |
| Fax Number: | 5302419221 |
| NPI Enumeration Date: | 01/15/2007 |
| NPI Last Update Date: | 11/06/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | MFC37996 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |