Provider Demographics
NPI:1952323933
Name:KALE, NANCY M (MSW LICSW)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:M
Last Name:KALE
Suffix:
Gender:F
Credentials:MSW LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 HARRIS PLACE
Mailing Address - Street 2:
Mailing Address - City:BRATTLEBORO
Mailing Address - State:VT
Mailing Address - Zip Code:05301-7127
Mailing Address - Country:US
Mailing Address - Phone:802-257-5002
Mailing Address - Fax:
Practice Address - Street 1:54 HARRIS PLACE
Practice Address - Street 2:
Practice Address - City:BRATTLEBORO
Practice Address - State:VT
Practice Address - Zip Code:05301-7127
Practice Address - Country:US
Practice Address - Phone:802-257-5002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10284421041C0700X
VT08900006341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1007689Medicaid
NH30422293Medicaid
VTVN1679Medicare PIN