Provider Demographics
NPI:1528407921
Name:CABLE, KATHLEEN M (LPC)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:M
Last Name:CABLE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 ALLEN ST
Mailing Address - Street 2:SUITE 2A - PO BOX 373
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-7652
Mailing Address - Country:US
Mailing Address - Phone:732-281-0275
Mailing Address - Fax:
Practice Address - Street 1:10 ALLEN ST
Practice Address - Street 2:SUITE 2A
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-7652
Practice Address - Country:US
Practice Address - Phone:732-281-0275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-19
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00041900101YM0800X
NJ37PC0041900101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health