Provider Demographics
NPI:1659423424
Name:KALER, JODY LYNN (EDS,LMHC,NCC)
Entity Type:Individual
Prefix:
First Name:JODY
Middle Name:LYNN
Last Name:KALER
Suffix:
Gender:F
Credentials:EDS,LMHC,NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 SE OCEAN BLVD
Mailing Address - Street 2:SUITE 232
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-2471
Mailing Address - Country:US
Mailing Address - Phone:772-287-3780
Mailing Address - Fax:772-287-3780
Practice Address - Street 1:900 SE OCEAN BLVD
Practice Address - Street 2:SUITE 232
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-2471
Practice Address - Country:US
Practice Address - Phone:772-287-3780
Practice Address - Fax:772-287-3780
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH2939101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA111408OtherVALUEOPTIONS
FLZ7409OtherBLUECROSS OF FL.