Provider Demographics
NPI:1780637843
Name:MICHALSKI, KAYLEE MARIE (MSW LISW CMSW)
Entity Type:Individual
Prefix:
First Name:KAYLEE
Middle Name:MARIE
Last Name:MICHALSKI
Suffix:
Gender:F
Credentials:MSW LISW CMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 W BROADWAY
Mailing Address - Street 2:HORIZON THERAPY GROUP LLC SUITE 270
Mailing Address - City:COUNCIL BLUFFS
Mailing Address - State:IA
Mailing Address - Zip Code:51503
Mailing Address - Country:US
Mailing Address - Phone:712-256-7511
Mailing Address - Fax:712-256-9766
Practice Address - Street 1:300 W BROADWAY
Practice Address - Street 2:HORIZON THERAPY GROUP LLC SUITE 270
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51503
Practice Address - Country:US
Practice Address - Phone:712-256-7511
Practice Address - Fax:712-256-9766
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE928NELMHP104100000X
IA01440IOWALISW104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0174334Medicaid
IAI3642Medicare ID - Type Unspecified