Provider Demographics
NPI:1356900518
Name:CALHOUN, KEVIN K
Entity type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:K
Last Name:CALHOUN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2337 ENGLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:EAST POINT
Mailing Address - State:GA
Mailing Address - Zip Code:30344-2207
Mailing Address - Country:US
Mailing Address - Phone:404-314-5455
Mailing Address - Fax:
Practice Address - Street 1:2337 ENGLEWOOD DR
Practice Address - Street 2:
Practice Address - City:EAST POINT
Practice Address - State:GA
Practice Address - Zip Code:30344-2207
Practice Address - Country:US
Practice Address - Phone:404-314-5455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-11
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician