Provider Demographics
NPI:1659170736
Name:KALCICH, ANDREW R (LLMSW)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:R
Last Name:KALCICH
Suffix:
Gender:
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 8TH ST
Mailing Address - Street 2:
Mailing Address - City:CALUMET
Mailing Address - State:MI
Mailing Address - Zip Code:49913-1615
Mailing Address - Country:US
Mailing Address - Phone:906-370-1318
Mailing Address - Fax:
Practice Address - Street 1:211 8TH ST
Practice Address - Street 2:
Practice Address - City:CALUMET
Practice Address - State:MI
Practice Address - Zip Code:49913-1615
Practice Address - Country:US
Practice Address - Phone:906-370-1318
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-11
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68511167371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical