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NPI Code Detail

MEDICARE: KALIE KLETT

MEDICARE: KALIE KLETT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor
2101YM0800XMental Health Counselor
3171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1922880749
Entity Type Code : Individual
Provider Name (Legal Business Name) : KALIE KLETT
Provider Business Mailing Address
First Line : 319 W MARKET ST
Second Line :
City : LIMA
State : OH
Zip : 45801-4713
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 319 W MARKET ST
Second Line :
City : LIMA
State : OH
Zip : 45801-4713
Country : US
Telephone Number : 567-294-9089
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2023
Last Update Date : 12/26/2023

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Directions to “ KALIE KLETT ” Practice Location

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