Provider Demographics
NPI:1215049978
Name:ADLER, KATHLEEN R (LCSW)
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:R
Last Name:ADLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6237 PRESIDENTIAL CT
Mailing Address - Street 2:STE B
Mailing Address - City:FT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33919
Mailing Address - Country:US
Mailing Address - Phone:239-433-1211
Mailing Address - Fax:239-482-5335
Practice Address - Street 1:6237 PRESIDENTIAL CT
Practice Address - Street 2:STE B
Practice Address - City:FT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33919
Practice Address - Country:US
Practice Address - Phone:239-433-1211
Practice Address - Fax:239-482-5335
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW21521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical