Provider Demographics
NPI:1356378806
Name:MCBRIDE, KATHLEEN (LPC)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:MCBRIDE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 GORDONS CORNER ROAD
Mailing Address - Street 2:SUITE 2F
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726
Mailing Address - Country:US
Mailing Address - Phone:732-792-1444
Mailing Address - Fax:732-385-7406
Practice Address - Street 1:215 GORDONS CORNER ROAD
Practice Address - Street 2:SUITE 2F
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726
Practice Address - Country:US
Practice Address - Phone:732-792-1444
Practice Address - Fax:732-385-7406
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00293400101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional