Provider Demographics
NPI:1588733323
Name:MCGRATH, ISOBEL J (LMHC, CAC)
Entity type:Individual
Prefix:MRS
First Name:ISOBEL
Middle Name:J
Last Name:MCGRATH
Suffix:
Gender:F
Credentials:LMHC, CAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 VILLAGE DEL LAGO CIR
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32080-2526
Mailing Address - Country:US
Mailing Address - Phone:904-461-9471
Mailing Address - Fax:904-829-9768
Practice Address - Street 1:1100 S PONCE DE LEON BLVD STE 1
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32084-6013
Practice Address - Country:US
Practice Address - Phone:904-806-8840
Practice Address - Fax:904-829-9768
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH9699101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health