Provider Demographics
NPI:1477178986
Name:RICKERT-KAUFFMAN, KAILIN E (LCSW)
Entity type:Individual
Prefix:
First Name:KAILIN
Middle Name:E
Last Name:RICKERT-KAUFFMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KAILIN
Other - Middle Name:E
Other - Last Name:KAUFFMAN-JEWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:700 REGENT ST
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53715-2634
Mailing Address - Country:US
Mailing Address - Phone:608-567-4465
Mailing Address - Fax:
Practice Address - Street 1:700 REGENT ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53715-2634
Practice Address - Country:US
Practice Address - Phone:608-567-4465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-10
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI9965-1231041C0700X
WI99651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical