Provider Demographics
NPI:1366791147
Name:MCCABE, KATHRYN ZEZIMA (LCSW)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:ZEZIMA
Last Name:MCCABE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:ZEZIMA
Other - Last Name:MCCABE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:3 SYLVAN RD S
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-4639
Mailing Address - Country:US
Mailing Address - Phone:203-326-6730
Mailing Address - Fax:203-326-6731
Practice Address - Street 1:3 SYLVAN RD S
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-4639
Practice Address - Country:US
Practice Address - Phone:203-326-6730
Practice Address - Fax:203-326-6731
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-07
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0084301041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical