Provider Demographics
NPI:1427357367
Name:KALIKOW, EILEEN
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:
Last Name:KALIKOW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:477 CONGRESS ST
Mailing Address - Street 2:SUITE 418
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04101-3427
Mailing Address - Country:US
Mailing Address - Phone:207-772-2323
Mailing Address - Fax:207-774-1300
Practice Address - Street 1:477 CONGRESS ST
Practice Address - Street 2:SUITE 418
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101-3427
Practice Address - Country:US
Practice Address - Phone:207-772-2323
Practice Address - Fax:207-774-1300
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-17
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor