Provider Demographics
NPI:1326606369
Name:KALKASKA COUNSELING SERVICES, PLLC
Entity Type:Organization
Organization Name:KALKASKA COUNSELING SERVICES, PLLC
Other - Org Name:LAUREN BERTHELOT, LMSW
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:LAUREN
Authorized Official - Last Name:BERTHELOT
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:231-944-0384
Mailing Address - Street 1:PO BOX 2257
Mailing Address - Street 2:
Mailing Address - City:CHESTERTON
Mailing Address - State:IN
Mailing Address - Zip Code:46304-0357
Mailing Address - Country:US
Mailing Address - Phone:219-926-8320
Mailing Address - Fax:
Practice Address - Street 1:880 MUNSON AVE STE G
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49686-3661
Practice Address - Country:US
Practice Address - Phone:231-944-0384
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-04
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty