Provider Demographics
NPI:1720219595
Name:MADAY, KATHRYN (LISW-CP/AP)
Entity Type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:
Last Name:MADAY
Suffix:
Gender:F
Credentials:LISW-CP/AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 PLANTERS RST
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-8121
Mailing Address - Country:US
Mailing Address - Phone:843-768-3545
Mailing Address - Fax:
Practice Address - Street 1:603 PLANTERS RST
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-8121
Practice Address - Country:US
Practice Address - Phone:843-768-3545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-28
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC005665104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker