Provider Demographics
NPI:1376777656
Name:ADORETTI, KALIE N (LCPC, MSW)
Entity Type:Individual
Prefix:
First Name:KALIE
Middle Name:N
Last Name:ADORETTI
Suffix:
Gender:F
Credentials:LCPC, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2485 RIVERSIDE RD
Mailing Address - Street 2:
Mailing Address - City:BIGFORK
Mailing Address - State:MT
Mailing Address - Zip Code:59911-6008
Mailing Address - Country:US
Mailing Address - Phone:406-212-4985
Mailing Address - Fax:
Practice Address - Street 1:2485 RIVERSIDE RD
Practice Address - Street 2:
Practice Address - City:BIGFORK
Practice Address - State:MT
Practice Address - Zip Code:59911-6008
Practice Address - Country:US
Practice Address - Phone:406-212-4985
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-14
Last Update Date:2011-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1384101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT1477745370Medicaid