Provider Demographics
NPI:1255162657
Name:COLLABORATIVE HEALING AND INTEGRATIVE THERAPY, LLC
Entity type:Organization
Organization Name:COLLABORATIVE HEALING AND INTEGRATIVE THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH THERAPIST, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAYLYNNE
Authorized Official - Middle Name:
Authorized Official - Last Name:KALBERG
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:541-749-0575
Mailing Address - Street 1:61165 S HWY 97 STE 110
Mailing Address - Street 2:#337
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-4012
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:22012 SWEETGRASS DR
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-9620
Practice Address - Country:US
Practice Address - Phone:541-749-0575
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-08
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty