Provider Demographics
NPI:1831676592
Name:MCCARTER, KERRY LYNN (LICSW)
Entity Type:Individual
Prefix:
First Name:KERRY
Middle Name:LYNN
Last Name:MCCARTER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3033 NW 70TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98117-6221
Mailing Address - Country:US
Mailing Address - Phone:206-783-9300
Mailing Address - Fax:
Practice Address - Street 1:200 W MERCER ST STE E407
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98119-3958
Practice Address - Country:US
Practice Address - Phone:206-459-7994
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-25
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA608640361041C0700X
WALW611660921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical