Provider Demographics
NPI:1689838807
Name:TAYLOR, KALONI KAYE (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:KALONI
Middle Name:KAYE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2319 15TH AVE S
Mailing Address - Street 2:#2
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405-5036
Mailing Address - Country:US
Mailing Address - Phone:406-231-1114
Mailing Address - Fax:
Practice Address - Street 1:2319 15TH AVE S
Practice Address - Street 2:#2
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-5036
Practice Address - Country:US
Practice Address - Phone:406-231-1114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT434-LCSW101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0000071471OtherCHIPS