Provider Demographics
NPI:1386086981
Name:CAHILL, MARY CATHERINE (LMFT)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:CATHERINE
Last Name:CAHILL
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2279
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95063-2279
Mailing Address - Country:US
Mailing Address - Phone:650-281-5118
Mailing Address - Fax:
Practice Address - Street 1:104 WALNUT AVE STE 208
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060-3929
Practice Address - Country:US
Practice Address - Phone:650-281-5118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-24
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT28306106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist