Provider Demographics
NPI:1033551635
Name:KIRK, KATHRYN NAYLOR (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:NAYLOR
Last Name:KIRK
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 1:2558 ROOSEVELT ST STE 202
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-1673
Mailing Address - Country:US
Mailing Address - Phone:760-889-5540
Mailing Address - Fax:
Practice Address - Street 1:2558 ROOSEVELT ST STE 202
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-1673
Practice Address - Country:US
Practice Address - Phone:760-889-5540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-23
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC44312106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist