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Individual
MAEVE KENNEDY GORMLY
Active
Individual
MAEVE KENNEDY GORMLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
61896
CA
1041C0700X
Clinical Social Worker
Primary
82235
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
82235
BOARD OF BEHAVIORAL SCIENCES
CA
Enumeration date
04/01/2016
Last updated
01/26/2021
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