Provider Demographics
NPI:1942371307
Name:KALI-SCHULTES, KIMBERLEE A (LCSW/LISW)
Entity Type:Individual
Prefix:MS
First Name:KIMBERLEE
Middle Name:A
Last Name:KALI-SCHULTES
Suffix:
Gender:F
Credentials:LCSW/LISW
Other - Prefix:MS
Other - First Name:KIM
Other - Middle Name:A
Other - Last Name:KLUESNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW/LISW
Mailing Address - Street 1:PO BOX 3086
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52004-3086
Mailing Address - Country:US
Mailing Address - Phone:563-213-8502
Mailing Address - Fax:877-836-1290
Practice Address - Street 1:1001 DAVIS ST
Practice Address - Street 2:SUITE 1
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-1306
Practice Address - Country:US
Practice Address - Phone:563-213-8502
Practice Address - Fax:877-836-1290
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0116381041C0700X
IA068121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA06812OtherLICENSED INDEPENDENT SW
ILK37268OtherMEDICARE PROVIDER #
IL149.011638OtherLICENSED CLINICAL SW