Provider Demographics
NPI:1770474405
Name:DEHAUT, KALENE (LCSW, MSW)
Entity type:Individual
Prefix:
First Name:KALENE
Middle Name:
Last Name:DEHAUT
Suffix:
Gender:F
Credentials:LCSW, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-2305
Mailing Address - Country:US
Mailing Address - Phone:610-858-5607
Mailing Address - Fax:
Practice Address - Street 1:13 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-2305
Practice Address - Country:US
Practice Address - Phone:610-858-5607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-11
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD17065104100000X
NY086834104100000X
NJ44SC065159001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker