Provider Demographics
NPI:1639764673
Name:KALSKI, STEFANIE YOUNG
Entity Type:Individual
Prefix:
First Name:STEFANIE
Middle Name:YOUNG
Last Name:KALSKI
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 1:9285 SW 220TH TER
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33190-1410
Mailing Address - Country:US
Mailing Address - Phone:305-632-5335
Mailing Address - Fax:
Practice Address - Street 1:14411 COMMERCE WAY STE 350
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-1600
Practice Address - Country:US
Practice Address - Phone:305-530-8119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-02
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL20763101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health