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KYLIE MARIE SHACKELFORD
NPI 1982492096
Counselor - Mental Health in Bend, OR

Active since April 28, 2025
61690 PETTIGREW RD, BEND, OR 97702(541) 617-0377(833) 776-0563 Get Directions Write a Review

NPPES record last updated: April 28, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Kylie Marie Shackelford NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KYLIE MARIE SHACKELFORD (NPI 1982492096) is an individual mental health provider in Bend, Oregon and active in the NPI registry since April 2025.

NPPES Registry Identity

NPI1982492096
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameKYLIE MARIE SHACKELFORD
Location Address61690 PETTIGREW RDBend, OR 97702-2422
Mailing Address61690 Pettigrew RdBend, OR 97702-2422 · (541) 617-0377 · Fax (833) 776-0563
Phone(541) 617-0377
Fax(833) 776-0563
Sole ProprietorYes
Enumeration DateApril 28, 2025
NPPES CertifiedApril 28, 2025
✔ NPI 1982492096 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
Also ListedCounselorTaxonomy 101Y00000X
61690 PETTIGREW RD, Bend, OR 97702
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NATALIE SOPHIA SCHWARTZBAUER QMHP
Counselor (Mental Health)
61690 PETTIGREW RD
BEND, OR 97702
Deschutes County (541) 324-0873
ELIZABETH HANLEY SZABO
Counselor (Mental Health)
61690 PETTIGREW RD
BEND, OR 97702
Deschutes County (541) 617-0377
MARK EDWARD POLING
Counselor (Mental Health)
61690 PETTIGREW RD
BEND, OR 97702
Deschutes County (541) 617-0377
MICHAEL SAGAERT
Counselor (Professional)
61690 PETTIGREW RD
BEND, OR 97702
Deschutes County (541) 617-0377
SHAYLEE TAYLOR
Counselor (Mental Health)
61690 PETTIGREW RD
BEND, OR 97702
Deschutes County (541) 617-0377
MRS. ANDREA RENEE FARRIN BRADLEY LPC
Counselor (Mental Health)
61690 PETTIGREW RD
BEND, OR 97702
Deschutes County (541) 617-0377
LEANNA JOY RITTER LPC
Counselor (Mental Health)
61690 PETTIGREW RD
BEND, OR 97702
Deschutes County (541) 617-0377
MR. RYAN DYLAN GOLDSTEIN
Counselor (Mental Health)
61690 PETTIGREW RD
BEND, OR 97702
Deschutes County (541) 617-0377

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kylie Shackelford's NPI number?

The NPI number for Kylie Shackelford is 1982492096. It was assigned to this individual provider in the NPPES registry on April 28, 2025.

Where is Kylie Shackelford located?

Kylie Shackelford practices at 61690 Pettigrew Rd, Bend, OR 97702. The listed phone number is (541) 617-0377.

What is Kylie Shackelford's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Kylie Shackelford was last updated on April 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.