Provider Demographics
NPI:1457470601
Name:KALAT, STEPHEN S (PHD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:S
Last Name:KALAT
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 S MONROE ST
Mailing Address - Street 2:SUITE 350
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-3705
Mailing Address - Country:US
Mailing Address - Phone:303-321-7102
Mailing Address - Fax:303-393-7046
Practice Address - Street 1:360 S MONROE ST
Practice Address - Street 2:SUITE 350
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-3705
Practice Address - Country:US
Practice Address - Phone:303-321-7102
Practice Address - Fax:303-393-7046
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO619103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO91646Medicare PIN