Provider Demographics
NPI:1700498094
Name:KALITTA, AMBER M (LLMSW)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:M
Last Name:KALITTA
Suffix:
Gender:F
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:PO BOX 427
Mailing Address - Street 2:
Mailing Address - City:HILLMAN
Mailing Address - State:MI
Mailing Address - Zip Code:49746-0427
Mailing Address - Country:US
Mailing Address - Phone:989-354-2197
Mailing Address - Fax:989-354-1952
Practice Address - Street 1:609 W CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:MACKINAW CITY
Practice Address - State:MI
Practice Address - Zip Code:49701-9650
Practice Address - Country:US
Practice Address - Phone:231-597-9585
Practice Address - Fax:989-734-7390
Is Sole Proprietor?:No
Enumeration Date:2020-08-19
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical