Provider Demographics
NPI:1285907808
Name:MCCABE, KATHRYN LYDEN (LCSW)
Entity type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:LYDEN
Last Name:MCCABE
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 1:2801 FRUITVILLE RD STE 110
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34237-5336
Mailing Address - Country:US
Mailing Address - Phone:941-677-1792
Mailing Address - Fax:
Practice Address - Street 1:2801 FRUITVILLE RD STE 110
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34237-5336
Practice Address - Country:US
Practice Address - Phone:941-993-4516
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-13
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW105741041C0700X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical