MEDICARE: CAYLEN NICOLE BERG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	528846	MN

General Provider Information

NPI Number	:	1467240416
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAYLEN NICOLE BERG

Provider Business Mailing Address
First Line	:	600 UPTOWN BLVD
Second Line	:
City	:	BROOKFIELD
State	:	WI
Zip	:	53045-1366
Country	:	US
Telephone Number	:	262-442-9471
Fax Number	:

Provider Business Practice Location Address
First Line	:	N14W23800 STONE RIDGE DR STE 110
Second Line	:
City	:	WAUKESHA
State	:	WI
Zip	:	53188-1144
Country	:	US
Telephone Number	:	262-696-5325
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/29/2025
Last Update Date	:	10/23/2025

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Directions to “ CAYLEN NICOLE BERG ” Practice Location

Language	Start Address	Practice Location

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