Provider Demographics
NPI:1306595038
Name:CALHOUN, KELLEY (MSSW, CSW)
Entity type:Individual
Prefix:
First Name:KELLEY
Middle Name:
Last Name:CALHOUN
Suffix:
Gender:F
Credentials:MSSW, CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 E SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:MUNFORDVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42765-9023
Mailing Address - Country:US
Mailing Address - Phone:270-696-3181
Mailing Address - Fax:
Practice Address - Street 1:102 WINSTON WAY STE 3
Practice Address - Street 2:
Practice Address - City:CAMPBELLSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42718-4991
Practice Address - Country:US
Practice Address - Phone:270-465-0078
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-21
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY256621104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker