| Kaleidoscope Mental Health, Pllc | |
|
722 Glenwood Dr Charleston IL 61920-3825 | |
| (217) 549-3741 | |
| Not Available |
| Full Name | Kaleidoscope Mental Health, Pllc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 722 Glenwood Dr, Charleston, Illinois |
| Authorized Official Name and Position | Sarah L Malak (OWNER) |
| Authorized Official Contact | 2175493741 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kaleidoscope Mental Health, Pllc 722 Glenwood Dr Charleston IL 61920-3825 Ph: (217) 549-3741 | Kaleidoscope Mental Health, Pllc 722 Glenwood Dr Charleston IL 61920-3825 Ph: (217) 549-3741 |
| NPI Number | 1609482843 |
|---|---|
| Provider Enumeration Date | 09/22/2020 |
| Last Update Date | 09/22/2020 |
| Certification Date | 09/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609482843 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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