Provider Demographics
NPI:1841430907
Name:MCFADDEN, KIRSTIE LYNN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KIRSTIE
Middle Name:LYNN
Last Name:MCFADDEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:KIRSTIE
Other - Middle Name:LYNN
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:PO BOX 244
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94701-0244
Mailing Address - Country:US
Mailing Address - Phone:510-926-6677
Mailing Address - Fax:510-756-0812
Practice Address - Street 1:1110 E CHAPMAN AVE STE 207
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92866-2145
Practice Address - Country:US
Practice Address - Phone:714-627-5477
Practice Address - Fax:510-756-0812
Is Sole Proprietor?:No
Enumeration Date:2009-03-03
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO13451041C0700X
CA1014411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical