Organization
KATHY MCNULTY, LCSW, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY MCNULTY LCSW (OWNER)
(630) 664-6036
Entity
Organization
Contact information
Practice address
2100 MANCHESTER RD, SUITE 400, WHEATON, IL 60187
(630) 664-6036
Mailing address
2100 MANCHESTER RD SUITE 400, WHEATON, IL 60187
(630) 664-6036
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
149-004463
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
149-004463
PROFESSIONAL LICENSE
IL
Enumeration date
06/23/2016
Last updated
08/20/2024
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