Kiley Huntington, LCSW
Individual provider Active NPI Clinical Social Worker · Bellemont, AZ
NPI 1508203480 · NPPES record last updated Jul 27, 2023
Key facts
- NPI
- 1508203480
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- LCSW-21663 (AZ)
- Practice address
- 11721 Pegasus Rd
Bellemont, AZ 86015-1018 - Phone
- (435) 632-5823
- NPI assigned
- May 31, 2013
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW-21663 | AZ | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCSW-21663 | AZ | Yes |
Addresses
Primary practice location
11721 Pegasus Rd
Bellemont, AZ 86015-1018
Mailing address
11721 Pegasus Rd
Bellemont, AZ 86015-1018
Phone (435) 632-5823
Other providers in Bellemont, AZ
- Gilberto Contreras
- Harriet Hill
- Shanon Landauer
- Ashley Dawn Lester
- Jamie Michelle Ornelas
- Ponderosa Fire District
- Ponderosa Senior Assisted Living, LLC
All providers in Bellemont, AZ · Clinical Social Worker in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 27, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.