Healthcare Provider Details

I. General information

NPI: 1144134891
Provider Name (Legal Business Name): NICOLE KAELBER CASAC-T
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 MARKET ST
POUGHKEEPSIE NY
12601-3204
US

IV. Provider business mailing address

33 CONKLIN ST APT 1
POUGHKEEPSIE NY
12601-2464
US

V. Phone/Fax

Practice location:
  • Phone: 845-486-3346
  • Fax:
Mailing address:
  • Phone: 914-456-1644
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCASAC-T-40209
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: