Provider Demographics
NPI:1124725809
Name:MCCABE, ABBY KIKLEVICH (PHD)
Entity type:Individual
Prefix:DR
First Name:ABBY
Middle Name:KIKLEVICH
Last Name:MCCABE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 TRAP RUN RD
Mailing Address - Street 2:
Mailing Address - City:FRIENDSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21531-1539
Mailing Address - Country:US
Mailing Address - Phone:240-321-1765
Mailing Address - Fax:
Practice Address - Street 1:446 GREENBAG RD
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26501-7159
Practice Address - Country:US
Practice Address - Phone:304-284-5360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-13
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1697103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty