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General NPI Number Information
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NPI Number | 1639588437
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Entity Type | Individual
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Provider Name | KAY A KINKEL LICSW
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Gender | Female
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Dates
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Enumeration Date | 08/05/2014
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Last Update Date | 03/06/2024
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Provider Practice Location Address
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Address Line | 800 WACONIA PKWY N
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City | WACONIA
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State | MN
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Zip | 55387-9241
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Country | US
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Telephone | 612-879-5320
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Fax | 612-879-5282
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Provider Business Mailing Address
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Address Line | 2400 PARK AVE
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City | MINNEAPOLIS
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State | MN
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Zip | 55404-3713
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Country | US
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Telephone | 612-879-5320
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Fax | 612-879-5282
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 23722
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 072155
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License Number State | IA
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