Provider Demographics
NPI:1083928154
Name:ROSHTO, KAL ANNETTE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KAL
Middle Name:ANNETTE
Last Name:ROSHTO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28260 NORMAN PAINTER RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT HERMON
Mailing Address - State:LA
Mailing Address - Zip Code:70450-4208
Mailing Address - Country:US
Mailing Address - Phone:985-966-2145
Mailing Address - Fax:985-839-0041
Practice Address - Street 1:28260 NORMAN PAINTER RD
Practice Address - Street 2:
Practice Address - City:MOUNT HERMON
Practice Address - State:LA
Practice Address - Zip Code:70450-4208
Practice Address - Country:US
Practice Address - Phone:985-966-2145
Practice Address - Fax:985-839-0041
Is Sole Proprietor?:No
Enumeration Date:2010-08-01
Last Update Date:2010-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA64941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical