Provider Demographics
NPI:1447396080
Name:KATHLEEN BROWN MCNALLY, LCSW, PC
Entity Type:Organization
Organization Name:KATHLEEN BROWN MCNALLY, LCSW, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:BROWN
Authorized Official - Last Name:MCNALLY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:516-313-0060
Mailing Address - Street 1:44 WALTER AVE.
Mailing Address - Street 2:
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801-5345
Mailing Address - Country:US
Mailing Address - Phone:516-313-0060
Mailing Address - Fax:
Practice Address - Street 1:44 WALTER AVE.
Practice Address - Street 2:
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-5345
Practice Address - Country:US
Practice Address - Phone:516-313-0060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR046916-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN3W941Medicare PIN