Provider Demographics
NPI:1548344054
Name:CAHILL, MARY KATHLEEN (LCSW)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:KATHLEEN
Last Name:CAHILL
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 1:2529 W BUSCH BLVD STE 800
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-4524
Mailing Address - Country:US
Mailing Address - Phone:813-935-6060
Mailing Address - Fax:813-933-8096
Practice Address - Street 1:2529 W BUSCH BLVD STE 800
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-4524
Practice Address - Country:US
Practice Address - Phone:813-935-6060
Practice Address - Fax:813-933-8096
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW0006191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL090861OtherOPTIONS
FLZ1004OtherBC/BS
FL1328OtherBC/BS HMO MHNET
FLZ1004OtherBC/BS
FL1328OtherBC/BS HMO MHNET