Provider Demographics
NPI:1184143257
Name:KALONICK, JANE KATHRYN (LSW)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:KATHRYN
Last Name:KALONICK
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:MRS
Other - First Name:JANE
Other - Middle Name:K
Other - Last Name:KALONICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:68353 BANNOCK RD
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIRSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43950-9736
Mailing Address - Country:US
Mailing Address - Phone:740-296-5214
Mailing Address - Fax:740-695-7778
Practice Address - Street 1:68353 BANNOCK RD
Practice Address - Street 2:
Practice Address - City:SAINT CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950-9736
Practice Address - Country:US
Practice Address - Phone:740-296-5214
Practice Address - Fax:740-695-7778
Is Sole Proprietor?:No
Enumeration Date:2017-09-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS1341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical