Individual ProviderKaylene Marie WhittenSocial WorkerBehavioral Health & Social Service ProvidersPractice Address1975 Curlew, Idaho Falls, ID 83406(208) 529-4300PECOS EnrollmentBased on the most recent information from CMS, provider Kaylene Marie Whitten does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1972606259Provider TypeIndividualFull NameWhitten, Kaylene MarieTitleMrs.CredentialLMSWGenderFemaleSole ProprietorNoEnumeration Date9/5/2006Last Updated7/8/2007Contact InformationPractice LocationPractice Address1975 Curlew, Idaho Falls, ID 83406Phone(208) 529-4300Fax(208) 529-1627Mailing LocationMailing Address2037 La Rain Ct, Idaho Falls, ID 83402-4853PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicenseLMSW-25177IdahoProvider IdentifiersIDDescriptionIssuerID000010148963DescriptionOtherIssuerREGENCE BLUE SHIELDIdaho