Provider Demographics
NPI:1548480106
Name:KALVELAGE, JOAN A (LPC)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:A
Last Name:KALVELAGE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:565 A ST UNIT 203
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-2092
Mailing Address - Country:US
Mailing Address - Phone:541-482-3418
Mailing Address - Fax:541-535-7135
Practice Address - Street 1:565 A ST UNIT 203
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-2092
Practice Address - Country:US
Practice Address - Phone:541-482-3418
Practice Address - Fax:541-535-7135
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC0065101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional