Provider Demographics
NPI:1790243269
Name:MCCARTHY, KAILA (MS LMFT)
Entity Type:Individual
Prefix:
First Name:KAILA
Middle Name:
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:MS LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10107 PALERMO CIR APT 202
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33619-5076
Mailing Address - Country:US
Mailing Address - Phone:334-300-8214
Mailing Address - Fax:
Practice Address - Street 1:6013 BRANDON CIR
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-3834
Practice Address - Country:US
Practice Address - Phone:813-413-7575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-04
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALL521106H00000X
AL198A106H00000X
FLMT4494106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist