Provider Demographics
NPI:1255654273
Name:KAELIN, MARGARET C (LCSW)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:C
Last Name:KAELIN
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 1:3622 THREE FORKS RD
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:TX
Mailing Address - Zip Code:76513-7788
Mailing Address - Country:US
Mailing Address - Phone:502-468-7626
Mailing Address - Fax:
Practice Address - Street 1:3622 THREE FORKS RD
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:TX
Practice Address - Zip Code:76513-7788
Practice Address - Country:US
Practice Address - Phone:502-468-7626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-04
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY33671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000652654OtherANTHEM
KYP400020984Medicare PIN