Provider Demographics
NPI:1659480895
Name:MCFADDEN, MARY CATHERINE (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:MARY
Middle Name:CATHERINE
Last Name:MCFADDEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:115 WHITTIER AVE
Mailing Address - Street 2:
Mailing Address - City:BEN LOMOND
Mailing Address - State:CA
Mailing Address - Zip Code:95005-9565
Mailing Address - Country:US
Mailing Address - Phone:650-493-5000
Mailing Address - Fax:650-849-1283
Practice Address - Street 1:115 WHITTIER AVE
Practice Address - Street 2:
Practice Address - City:BEN LOMOND
Practice Address - State:CA
Practice Address - Zip Code:95005-9565
Practice Address - Country:US
Practice Address - Phone:650-493-5000
Practice Address - Fax:650-849-1283
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMI-34861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical