Provider Demographics
NPI:1740632652
Name:MCDERMOTT, KAYLEIGH (MSW,LSW)
Entity type:Individual
Prefix:
First Name:KAYLEIGH
Middle Name:
Last Name:MCDERMOTT
Suffix:
Gender:F
Credentials:MSW,LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 S WOODWARD ST
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-4179
Mailing Address - Country:US
Mailing Address - Phone:610-435-1541
Mailing Address - Fax:610-435-4367
Practice Address - Street 1:900 S WOODWARD ST
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-4179
Practice Address - Country:US
Practice Address - Phone:610-435-1541
Practice Address - Fax:610-435-4367
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-05
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW1335341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical