| Kathy Mcnulty, Lcsw, Llc | |
|
1 Tiffany Point Suite 117 Bloomingdale IL 60108 | |
| (630) 664-6036 | |
| (630) 653-6214 |
| Full Name | Kathy Mcnulty, Lcsw, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1 Tiffany Point, Bloomingdale, Illinois |
| Authorized Official Name and Position | Kathy Mcnulty (LICENSED CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 6306646036 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kathy Mcnulty, Lcsw, Llc 1 Tiffany Point Suite 117 Bloomingdale IL 60108 Ph: (630) 664-6036 | Kathy Mcnulty, Lcsw, Llc 1 Tiffany Point Suite 117 Bloomingdale IL 60108 Ph: (630) 664-6036 |
| NPI Number | 1215388939 |
|---|---|
| Provider Enumeration Date | 06/23/2016 |
| Last Update Date | 06/23/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215388939 | NPI | - | NPPES |
| 149-004463 | Other | IL | PROFESSIONAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 149-004463 (Illinois) | Primary |
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