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Physician Compare National (NPI:1811424021)

HEALTHCARE PROVIDER: KATHLEEN MARIE MCNALLY LISW, LICDC

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1811424021
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 5597022343
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20171201002956
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name MCNALLY
Individual professional last name
Provider First Name KATHLEEN
Individual professional first name
Provider Middle Name MARIE
Individual professional middle name
Provider Gender F
The provider's gender if the provider is a person.

Medical School Information

Medical School Name OTHER
Individual professional's medical school
Graduation Year 2013
Individual professional's medical school graduation year
Primary Specialty CLINICAL SOCIAL WORKER
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Organization Legal Name NATIONAL YOUTH ADVOCATE PROGRAM INC
Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID 7719258292
Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members 6
Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address 501 MAIN ST
Group Practice or individual's line 1 address
City ZANESVILLE
Group Practice or individual's city
State OH
Group Practice or individual's state
Zip Code 437013622
Group Practice or individual's zip code (9 digits when available)
Phone Number 7407554730
Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information

Professional Accepts Medicare Assignment Y

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