Individual
KATHLEEN KELLY MCCAULEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, LISAC
Contact information
Practice address
2435 E SOUTHERN AVE, SUITE 4, TEMPE, AZ 85282-7628
(480) 216-4785
Mailing address
PO BOX 3862, CHANDLER, AZ 85244-3862
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LISAC 10224
AZ
1041C0700X
Clinical Social Worker
Primary
LCSW 11622
AZ
Other
Enumeration date
04/12/2011
Last updated
04/12/2011
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