Provider Demographics
NPI:1801507736
Name:WILES, KAITLYN LUMINITA (MSW)
Entity type:Individual
Prefix:
First Name:KAITLYN
Middle Name:LUMINITA
Last Name:WILES
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 EAST ST
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-5380
Mailing Address - Country:US
Mailing Address - Phone:413-770-1294
Mailing Address - Fax:
Practice Address - Street 1:251 FENN ST
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-5269
Practice Address - Country:US
Practice Address - Phone:413-496-9671
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-12
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical