Provider Demographics
NPI:1396141016
Name:KALOUS, MICHAEL (LCPC)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:
Last Name:KALOUS
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 139
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59624-0139
Mailing Address - Country:US
Mailing Address - Phone:406-442-7920
Mailing Address - Fax:406-442-7949
Practice Address - Street 1:500 S LAMBORN ST
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-5417
Practice Address - Country:US
Practice Address - Phone:406-442-7920
Practice Address - Fax:406-442-7949
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-06
Last Update Date:2017-07-17
Deactivation Date:2017-04-13
Deactivation Code:
Reactivation Date:2017-07-17
Provider Licenses
StateLicense IDTaxonomies
MTSWP-LCPC-LIC-8801101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health