Provider Demographics
NPI:1598090755
Name:DALY, KATHRYN W (LCSW)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:W
Last Name:DALY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:441 ERNEST CT
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92056-2408
Mailing Address - Country:US
Mailing Address - Phone:619-846-7950
Mailing Address - Fax:760-295-5707
Practice Address - Street 1:5672 STETSON PL
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92057-4829
Practice Address - Country:US
Practice Address - Phone:619-846-7950
Practice Address - Fax:760-295-5707
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-06
Last Update Date:2015-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 232301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical