| Kelly A. Kalt, Msw, Lcsw, Inc. | |
|
1639 N Alpine Rd Suite #403 Rockford IL 61107-1449 | |
| (815) 229-7102 | |
| (815) 229-7108 |
| Full Name | Kelly A. Kalt, Msw, Lcsw, Inc. |
|---|---|
| Speciality | Social Worker |
| Location | 1639 N Alpine Rd, Rockford, Illinois |
| Authorized Official Name and Position | Kelly Kalt (LICENSED CLINCIAL SOCIAL WORKER) |
| Authorized Official Contact | 8152297102 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kelly A. Kalt, Msw, Lcsw, Inc. 1639 N Alpine Rd Suite #403 Rockford IL 61107-1449 Ph: (815) 229-7102 | Kelly A. Kalt, Msw, Lcsw, Inc. 1639 N Alpine Rd Suite #403 Rockford IL 61107-1449 Ph: (815) 229-7102 |
| NPI Number | 1801114871 |
|---|---|
| Provider Enumeration Date | 05/14/2010 |
| Last Update Date | 05/14/2010 |
| Medicare PECOS PAC ID | 9032306717 |
|---|---|
| Medicare Enrollment ID | O20101207000753 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801114871 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Kelly A Kalt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063513513 PECOS PAC ID: 0941202345 Enrollment ID: I20070214000277 |
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