Provider Demographics
NPI:1356650121
Name:MCFADDEN MYERS, KATHLEEN (LCPC)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:
Last Name:MCFADDEN MYERS
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:MISS
Other - First Name:KATHLEEN
Other - Middle Name:JANA
Other - Last Name:MCFADDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCPC
Mailing Address - Street 1:416 WILLIAM PLUMMER ST
Mailing Address - Street 2:
Mailing Address - City:NEW MARKET
Mailing Address - State:MD
Mailing Address - Zip Code:21774-6516
Mailing Address - Country:US
Mailing Address - Phone:866-800-2569
Mailing Address - Fax:866-800-2569
Practice Address - Street 1:120 W CHURCH ST
Practice Address - Street 2:SUITE 2-D
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-7800
Practice Address - Country:US
Practice Address - Phone:866-800-2569
Practice Address - Fax:866-800-2569
Is Sole Proprietor?:No
Enumeration Date:2010-09-28
Last Update Date:2010-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC3663101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional