Provider Demographics
NPI:1154013241
Name:DEVITT, KELCIE CHRISTINE (LMSW)
Entity type:Individual
Prefix:
First Name:KELCIE
Middle Name:CHRISTINE
Last Name:DEVITT
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1579 W RIVERSTONE DR STE 101
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-1012
Mailing Address - Country:US
Mailing Address - Phone:208-435-0788
Mailing Address - Fax:
Practice Address - Street 1:1579 W RIVERSTONE DR STE 1100
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-5760
Practice Address - Country:US
Practice Address - Phone:208-435-0788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-25
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker