Provider Demographics
NPI:1205602257
Name:KALSBEEK, ANGELA MARIE (APSW)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:MARIE
Last Name:KALSBEEK
Suffix:
Gender:F
Credentials:APSW
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:MARIE
Other - Last Name:HALLORAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:HALLORAN
Mailing Address - Street 1:737 MEADOWBROOK LN
Mailing Address - Street 2:
Mailing Address - City:FOND DU LAC
Mailing Address - State:WI
Mailing Address - Zip Code:54935-2909
Mailing Address - Country:US
Mailing Address - Phone:920-946-0153
Mailing Address - Fax:
Practice Address - Street 1:115 N CENTER ST
Practice Address - Street 2:
Practice Address - City:BEAVER DAM
Practice Address - State:WI
Practice Address - Zip Code:53916-2119
Practice Address - Country:US
Practice Address - Phone:920-887-1766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-30
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI128957104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker