Provider Demographics
NPI:1124566971
Name:KALETSCH, SHPRESA (LCSW)
Entity Type:Individual
Prefix:
First Name:SHPRESA
Middle Name:
Last Name:KALETSCH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6497 PARKLAND DR STE A
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-4097
Mailing Address - Country:US
Mailing Address - Phone:941-212-2040
Mailing Address - Fax:
Practice Address - Street 1:6497 PARKLAND DR STE A
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34243-4097
Practice Address - Country:US
Practice Address - Phone:941-212-2040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-01
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW141741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical