Provider Demographics
NPI:1538213855
Name:WRIGHT, KYLA RAE KALANICK (LCPC)
Entity type:Individual
Prefix:MRS
First Name:KYLA
Middle Name:RAE KALANICK
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 CENTRAL AVE
Mailing Address - Street 2:SUITE #602
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59401-3154
Mailing Address - Country:US
Mailing Address - Phone:406-799-4737
Mailing Address - Fax:406-771-7805
Practice Address - Street 1:410 CENTRAL AVE
Practice Address - Street 2:SUITE #602
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59401-3154
Practice Address - Country:US
Practice Address - Phone:406-799-4737
Practice Address - Fax:406-771-7805
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1186 LCPC101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0256785Medicaid
MT742290OtherBLUE CROSS BLUE SHIELD