Provider Demographics
NPI:1629769476
Name:LACALAMETO, KAYLEE RAE (CDCA)
Entity Type:Individual
Prefix:
First Name:KAYLEE
Middle Name:RAE
Last Name:LACALAMETO
Suffix:
Gender:F
Credentials:CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9692 CINCINNATI COLUMBUS RD
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45241-1071
Mailing Address - Country:US
Mailing Address - Phone:513-515-8375
Mailing Address - Fax:
Practice Address - Street 1:9692 CINCINNATI COLUMBUS RD
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45241-1071
Practice Address - Country:US
Practice Address - Phone:937-991-0080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-15
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPS.003068175T00000X
OHCDCA.183307101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No175T00000XOther Service ProvidersPeer Specialist