Provider Demographics
NPI:1598875411
Name:KANE, CAROL LYNN (MA LMHC)
Entity Type:Individual
Prefix:
First Name:CAROL LYNN
Middle Name:
Last Name:KANE
Suffix:
Gender:F
Credentials:MA LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6228 VAN BUREN STREET
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34653-3741
Mailing Address - Country:US
Mailing Address - Phone:813-244-0783
Mailing Address - Fax:727-846-7200
Practice Address - Street 1:10335 CROSS CREEK BOULEVARD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647
Practice Address - Country:US
Practice Address - Phone:813-244-0783
Practice Address - Fax:727-846-7200
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH7144101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health