Individual provider Active NPI

Shaylynne Danielle Kalberg, LCSW

  • Clinical Social Worker
  • Bend, OR
National Provider Identifier
1972137875
Registry record updated Jun 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L7853 Issued in OR
Practice address
360 SW Bond St Ste 330
Bend, OR 97702-3556
Phone
(541) 706-2768
NPI assigned
Feb 28, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X L7853 OR Primary

Addresses

Primary practice location

360 SW Bond St Ste 330
Bend, OR 97702-3556

Mailing address

22012 Sweetgrass Dr
Bend, OR 97702-9620
Phone (541) 749-0575

Other names 1

  • Shaylynne Danielle Caito Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200617002942 OR Practitioner - Clinical Social Worker 4587086640 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Charles Health System IncGroup PAC ID 3870402852, 174 clinicians

Practice addresses (Care Compare)

1253 NW Canal Blvd
Redmond, OR 97756-1334
Phone (541) 548-8131

360 SW Bond St
Suite 330
Bend, OR 97702-3556
Phone (541) 706-2768

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L7853ORMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
St. Charles Health System, Inc. Current Accepting new patients
St. Charles Health System, Inc. CurrentSince May 1, 2020 Accepting new patients
St. Charles Health System, Inc. CurrentSince May 1, 2020 Accepting new patients
Collaborative Healing and Integrative Therapy, LLC Clinical CurrentSince Aug 11, 2024 Accepting new patients

Locations

29358 Network Pl
Chicago, IL 60673

2500 NE Neff Rd
Bend, OR 97701
Phone (541) 388-4333

2542 NE Courtney Dr
Bend, OR 97701
Phone (541) 322-2768

360 SW Bond St
Ste 330
Bend, OR 97702
Phone (541) 706-7730

1253 NW Canal Blvd
Redmond, OR 97756
Phone (541) 548-8131

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1582848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655337600000",
    "number": "1972137875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22012 SWEETGRASS DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977029620",
            "telephone_number": "541-749-0575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 SW BOND ST STE 330",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023556",
            "telephone_number": "541-706-2768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALBERG",
        "first_name": "SHAYLYNNE",
        "middle_name": "DANIELLE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-28",
        "last_updated": "2022-06-16",
        "certification_date": "2022-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L7853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAYLYNNE",
            "last_name": "CAITO",
            "middle_name": "DANIELLE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.