Healthcare Provider Details

I. General information

NPI: 1255109286
Provider Name (Legal Business Name): KAYLIN KEALY LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2023
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1071 MN-15 PLAZA 15
HUTCHINSON MN
55350
US

IV. Provider business mailing address

1071 MN-15 PLAZA 15
HUTCHINSON MN
55350
US

V. Phone/Fax

Practice location:
  • Phone: 320-484-4610
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number32431
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: