Provider Demographics
NPI:1174321525
Name:DICKERSON, KATHRYN MCCAFFERTY (LCSW)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:MCCAFFERTY
Last Name:DICKERSON
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 1:8261 TIMBER OAKS CV
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-9138
Mailing Address - Country:US
Mailing Address - Phone:731-803-1741
Mailing Address - Fax:
Practice Address - Street 1:8261 TIMBER OAKS CV
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-9138
Practice Address - Country:US
Practice Address - Phone:731-803-1741
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN69661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical