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General NPI Number Information
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NPI Number | 1801114871
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Entity Type | Organization
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Legal Business Name | KELLY A. KALT, MSW, LCSW, INC.
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Dates
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Enumeration Date | 05/14/2010
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Last Update Date | 07/09/2025
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Provider Practice Location Address
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Address Line | 1639 N ALPINE RD SUITE #403
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City | ROCKFORD
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State | IL
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Zip | 61107-1449
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Country | US
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Telephone | 815-229-7102
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Fax | 815-229-7108
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Provider Business Mailing Address
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Address Line | 1639 N ALPINE RD SUITE #403
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City | ROCKFORD
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State | IL
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Zip | 61107-1449
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Country | US
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Telephone | 815-229-7102
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Fax | 815-229-7108
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Authorized Official
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Title or Position | LICENSED CLINCIAL SOCIAL WORKER
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Name | KELLY KALT
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Credential | MSW, LCSW
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Telephone | 815-229-7102
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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