Provider Demographics
NPI:1972137875
Name:KALBERG, SHAYLYNNE DANIELLE (LCSW)
Entity Type:Individual
Prefix:
First Name:SHAYLYNNE
Middle Name:DANIELLE
Last Name:KALBERG
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SHAYLYNNE
Other - Middle Name:DANIELLE
Other - Last Name:CAITO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:22012 SWEETGRASS DR
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-9620
Mailing Address - Country:US
Mailing Address - Phone:541-749-0575
Mailing Address - Fax:
Practice Address - Street 1:360 SW BOND ST STE 330
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-3556
Practice Address - Country:US
Practice Address - Phone:541-706-2768
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-28
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL78531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical