Provider Demographics
NPI:1881319531
Name:CALENDRILLO, CHEYANN (MS, LAC)
Entity type:Individual
Prefix:
First Name:CHEYANN
Middle Name:
Last Name:CALENDRILLO
Suffix:
Gender:F
Credentials:MS, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 PONY LN
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:MT
Mailing Address - Zip Code:59047-8971
Mailing Address - Country:US
Mailing Address - Phone:406-223-9604
Mailing Address - Fax:
Practice Address - Street 1:3 PONY LN
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:MT
Practice Address - Zip Code:59047-8971
Practice Address - Country:US
Practice Address - Phone:406-223-9604
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-05
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT57472101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)