Provider Demographics
NPI:1356138002
Name:MCTAGGART, KACIE LAUREN
Entity type:Individual
Prefix:
First Name:KACIE
Middle Name:LAUREN
Last Name:MCTAGGART
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:534 VIEW POINT WAY
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22405-1284
Mailing Address - Country:US
Mailing Address - Phone:402-677-4960
Mailing Address - Fax:402-677-4960
Practice Address - Street 1:534 VIEW POINT WAY
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22405-1284
Practice Address - Country:US
Practice Address - Phone:402-677-4960
Practice Address - Fax:402-677-4960
Is Sole Proprietor?:No
Enumeration Date:2025-04-24
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst