Provider Demographics
NPI:1003033291
Name:MCINERNEY, CATHLEEN M (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:CATHLEEN
Middle Name:M
Last Name:MCINERNEY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 MATTHEW ST
Mailing Address - Street 2:
Mailing Address - City:PROSPECT
Mailing Address - State:CT
Mailing Address - Zip Code:06712-1417
Mailing Address - Country:US
Mailing Address - Phone:203-758-3296
Mailing Address - Fax:
Practice Address - Street 1:965 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06706-1434
Practice Address - Country:US
Practice Address - Phone:203-596-9724
Practice Address - Fax:203-759-0566
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001155106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist